Perinatal Quality Indicators: Measuring Maternal and Newborn Care

The Importance of Perinatal Quality Measurement

Perinatal care represents a unique area of quality measurement because it involves the health of both mother and infant. Quality indicators in this domain focus on reducing preventable harm during pregnancy, labor, delivery, and the postpartum period. Organizations such as The Joint Commission, CMS, and the National Quality Forum (NQF) have endorsed specific perinatal measures. CPHQ candidates should understand the clinical rationale behind these measures and the data collection processes that support them.

Key Perinatal Quality Measures

Core perinatal measures include the rate of elective deliveries before 39 weeks of gestation, cesarean section rates for low-risk first-birth mothers (the NTSV cesarean rate), exclusive breast milk feeding, antenatal steroid administration for preterm births, and screening for hepatitis B status. The PC-01 measure (elective delivery before 39 weeks) was one of the first perinatal measures to gain widespread adoption and has driven significant reductions in early elective deliveries nationwide. Each measure requires careful documentation and clinical workflow integration to ensure compliance.

Maternal Morbidity and Mortality Review

Severe maternal morbidity (SMM) and maternal mortality reviews are increasingly important components of perinatal quality programs. These reviews use structured frameworks to analyze adverse outcomes, identify contributing factors, and recommend system-level changes. Many states have established maternal mortality review committees that provide statewide data and recommendations. Quality professionals coordinate internal case reviews, track SMM rates, and implement evidence-based safety bundles to prevent hemorrhage, hypertensive emergencies, and venous thromboembolism.

Neonatal Quality Indicators

Neonatal quality measures track outcomes such as neonatal intensive care unit (NICU) admission rates, rates of birth trauma, neonatal abstinence syndrome management, and adherence to evidence-based practices in NICU care. The Vermont Oxford Network is a widely used collaborative that benchmarks NICU quality across participating hospitals. Quality professionals working in perinatal care must understand both maternal and neonatal measures to provide comprehensive oversight of care quality.

Improvement Strategies and Collaboratives

Perinatal quality improvement frequently involves participation in state or national collaboratives. The Alliance for Innovation on Maternal Health (AIM) provides evidence-based safety bundles that hospitals implement through structured improvement projects. Simulation training for obstetric emergencies, standardized protocols for high-risk conditions, and multidisciplinary team debriefings after adverse events are common improvement strategies. Quality professionals facilitate these efforts by providing data, coordinating education, and tracking progress toward improvement goals.