Feasibility of establishing a Canadian Obstetric Survey System (CanOSS) for severe maternal morbidity: a study protocol
Marian Knight,
Maria B Ospina,
K S Joseph,
Amy Metcalfe,
Heather Scott,
Deshayne B Fell,
Thomas van den Akker,
Jon Barrett,
Prakesh Shah,
Beth Murray-Davis,
Rohan D’Souza,
Stephen Lapinsky,
Sara Thorne,
Milena Forte,
Jocelynn Cook,
Rebecca J Seymour,
Susie Dzakpasu,
Leslie Skeith,
Rizwana Ashraf,
Josie Chundamala,
Sarah A Hutchinson,
Kenneth K Chen,
Isabelle Malhamé
Affiliations
Marian Knight
5University of Oxford, Nuffield Department of Population Health, Oxford, UK
Maria B Ospina
Department of Public Health Sciences, Queen`s University, Kingston, Ontario, Canada
K S Joseph
Department of Obstetrics & Gynaecology, The University of British Columbia, Vancouver, British Columbia, Canada
Amy Metcalfe
Department of Community Health Sciences, Department of Obstetrics & Gynaecology, and Department of Medicine, University of Calgary, Calgary, Alberta, Canada
Heather Scott
Department of Obstetrics & Gynaecology, Dalhousie University and the IWK Health Centre, Halifax, Nova Scotia, Canada
Deshayne B Fell
School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
Thomas van den Akker
10 Athena Institute, VU Amsterdam, Amsterdam, The Netherlands
Jon Barrett
Department of Obstetrics and Gynecology, McMaster University, Hamilton, ON, Canada
Prakesh Shah
Department of Pediatrics, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
Beth Murray-Davis
McMaster Midwifery Research Centre, McMaster University, Hamilton, Ontario, Canada
Rohan D’Souza
4 Department of Obstetrics & Gynaecology and Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
Stephen Lapinsky
Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Ontario, Canada
Sara Thorne
Division of Cardiology, Pregnancy & Heart Disease Program, University of Toronto, Toronto, Ontario, Canada
Milena Forte
Department of Family and Community Medicine, Mount Sinai Hospital, Toronto, Ontario, Canada
Jocelynn Cook
Society of Obstetricians and Gynaecologists, Ottawa, Ontario, Canada
Rebecca J Seymour
Department of Obstetrics & Gynaecology, McMaster University, Hamilton, Ontario, Canada
Susie Dzakpasu
Maternal and Infant Health Section, Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, Ontario, Canada
Leslie Skeith
Division of Hematology and Hematological Malignancies, Department of Medicine, University of Calgary, Calgary, Alberta, Canada
Rizwana Ashraf
Department of Obstetrics & Gynaecology, McMaster University, Hamilton, Ontario, Canada
Josie Chundamala
Department of Obstetrics & Gynaecology, Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
Sarah A Hutchinson
Department of Obstetrics & Gynaecology, Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
Kenneth K Chen
Departments of Medicine and Obstetrics & Gynecology, Women and Infants Hospital of Rhode Island, Providence, Rhode Island, USA
Isabelle Malhamé
2Department of Medicine, Division of General Internal Medicine, McGill University Health Centre, Canada
Introduction Severe maternal morbidity (SMM)—an unexpected pregnancy-associated maternal outcome resulting in severe illness, prolonged hospitalisation or long-term disability—is recognised by many, as the preferred indicator of the quality of maternity care, especially in high-income countries. Obtaining comprehensive details on events and circumstances leading to SMM, obtained through maternity units, could complement data from large epidemiological studies and enable targeted interventions to improve maternal health. The aim of this study is to assess the feasibility of gathering such data from maternity units across Canadian provinces and territories, with the goal of establishing a national obstetric survey system for SMM in Canada.Methods and analysis We propose a sequential explanatory mixed-methods study. We will first distribute a cross-sectional survey to leads of all maternity units across Canada to gather information on (1) Whether the unit has a system for reviewing SMM and the nature and format of this system, (2) Willingness to share anonymised data on SMM by direct entry using a web-based platform and (3) Respondents’ perception on the definition and leading causes of SMM at a local level. This will be followed by semistructured interviews with respondent groups defined a priori, to identify barriers and facilitators for data sharing. We will perform an integrated analysis to determine feasibility outcomes, a narrative description of barriers and facilitators for data-sharing and resource implications for data acquisition on an annual basis, and variations in top-5 causes of SMM.Ethics and dissemination The study has been approved by the Mount Sinai and Hamilton Integrated Research Ethics Boards. The study findings will be presented at annual scientific meetings of the Society of Obstetricians and Gynaecologists of Canada, North American Society of Obstetric Medicine, and International Network of Obstetric Survey Systems and published in an open-access peer-reviewed Obstetrics and Gynaecology or General Internal Medicine journal.
