INDICATOR DEVELOPMENT

To develop and test a list of perinatal health indicators, EURO-PERISTAT enlisted the assistance of perinatal health professionals (clinicians, epidemiologists, and statisticians) from EU member states and Norway, and consulted with other networks like SCPE, Eurocat, and Euroneonet.

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This indicator set was developed by a procedure that began with an extensive review of existing perinatal health indicators. The resulting list was used as the basis of a DELPHI consensus process, a formalised method in which a panel of experts responds to a successive series of questionnaires with the aim of achieving a consensus on key principles or proposals. Our first panel in 2002 was composed of clinicians, epidemiologists, and statisticians from the then 15 member states. We also invited the Surveillance of Cerebral Palsy in Europe (SCPE) Network to assist with the indicator on cerebral palsy. A second DELPHI process was also conducted in 2002, with a panel of midwives to ensure that their perspectives on perinatal health were represented. Finally, a third DELPHI process was conducted in 2006 with a panel of 2 participants (clinicians, epidemiologists, and statisticians) from each of the ten new member states. A study using data for the year 2000 was conducted to assess the feasibility of the EURO-PERISTAT indicators; the results were published in a special issue of the European Journal of Obstetrics Gynecology and Reproductive Biology and used for detailed analyses of health indicators in Europe. These articles can be downloaded here.

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In 2012, the EURO-PERISTAT indicators were updated based on our experiences with the European Perinatal Health Report and the assessments of our Scientific Committee (SC) about the continued relevance of the indicators. The SC reviewed each indicator and commented on its utility and its definition. SC members could also propose new indicators. This process led to several modifications of our list. A new indicator, “R12. Distribution of mothers’ pre-pregnancy body mass index (BMI)” was added, to reflect concerns with the rise of obesity among women in Europe. Two indicators for further development were removed from the list (fecal incontinence and postpartum depression) because the group considered that data from routine systems were not sufficient for producing these indicators routinely.

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For other indicators, definitions were refined or expanded.