Collaborative maternity and newborn dashboard (CoMaND) for the COVID-19 pandemic: a protocol for timely, adaptive monitoring of perinatal outcomes in Melbourne, Australia

Lisa Hui; Melvin B Marzan; Stephanie Potenza; Daniel L Rolnik; Joanne M Said; Kirsten R Palmer; Clare L Whitehead; Penelope M Sheehan; Jolyon Ford; Natasha Pritchard; Ben W Mol; Susan P Walker

doi:10.1136/bmjopen-2021-055902

Collaborative maternity and newborn dashboard (CoMaND) for the COVID-19 pandemic: a protocol for timely, adaptive monitoring of perinatal outcomes in Melbourne, Australia

BMJ Open. 2021 Nov 23;11(11):e055902. doi: 10.1136/bmjopen-2021-055902.

Authors

Lisa Hui^{1

2

3

4}, Melvin B Marzan⁵, Stephanie Potenza⁶, Daniel L Rolnik^{7

8}, Joanne M Said^{5

9}, Kirsten R Palmer^{7

8}, Clare L Whitehead^{5

10}, Penelope M Sheehan^{7

11}, Jolyon Ford¹², Natasha Pritchard^{5

2}, Ben W Mol^{7

8}, Susan P Walker^{5

2}

Affiliations

¹ Department of Obstetrics and Gynaecology, Melbourne Medical School, The University of Melbourne, Melbourne, Victoria, Australia lisa.hui@unimelb.edu.au.
² Department of Perinatal Medicine, Mercy Hospital for Women, Heidelberg, Victoria, Australia.
³ Department of Obstetrics and Gynaecology, The Northern Hospital, Northern Health, Epping, Victoria, Australia.
⁴ Reproductive Epidemiology Group, Murdoch Children's Research Institute, Parkville, Victoria, Australia.
⁵ Department of Obstetrics and Gynaecology, Melbourne Medical School, The University of Melbourne, Melbourne, Victoria, Australia.
⁶ Department of Obstetrics and Gynaecology, Mercy Hospital for Women, Heidelberg, Victoria, Australia.
⁷ Department of Obstetrics and Gynaecology, Monash University, Clayton, Victoria, Australia.
⁸ Department of Obstetrics and Gynaecology, Monash Medical Centre, Monash Health, Clayton, Victoria, Australia.
⁹ Department of Maternal-Fetal Medicine, Joan Kirner Women's and Children's Hospital, Western Health, St Albans, Victoria, Australia.
¹⁰ Department of Obstetrics and Gynaecology, The Royal Women's Hospital, Parkville, Victoria, Australia.
¹¹ Department of Obstetrics and Gynaecology, Box Hill Hospital, Eastern Health, Box Hill, Victoria, Australia.
¹² Department of Obstetrics and Gynaecology, Frankston Hospital, Peninsula Health, Frankston, Victoria, Australia.

Abstract

Background: The COVID-19 pandemic has resulted in a range of unprecedented disruptions to maternity care with documented impacts on perinatal outcomes such as stillbirth and preterm birth. Metropolitan Melbourne has endured one of the longest and most stringent lockdowns in globally. This paper presents the protocol for a multicentre study to monitor perinatal outcomes in Melbourne, Australia, during the COVID-19 pandemic.

Methods: Multicentre observational study analysing monthly deidentified maternal and newborn outcomes from births >20 weeks at all 12 public maternity services in Melbourne. Data will be merged centrally to analyse outcomes and create run charts according to established methods for detecting non-random 'signals' in healthcare. Perinatal outcomes will include weekly rates of total births, stillbirths, preterm births, neonatal intensive care admissions, low Apgar scores and fetal growth restriction. Maternal outcomes will include weekly rates of: induced labour, caesarean section, births before arrival to hospital, postpartum haemorrhage, length of stay, general anaesthesia for caesarean birth, influenza and COVID-19 vaccination status, and gestation at first antenatal visit. A prepandemic median for all outcomes will be calculated for the period of January 2018 to March 2020. A significant shift is defined as ≥6 consecutive weeks, all above or below the prepandemic median. Additional statistical analyses such as regression, time series and survival analyses will be performed for an in-depth examination of maternal and perinatal outcomes of interests.

Ethics and dissemination: Ethics approval for the collaborative maternity and newborn dashboard project has been obtained from the Austin Health (HREC/64722/Austin-2020) and Mercy Health (ref. 2020-031).

Trial registration number: ACTRN12620000878976; Pre-results.

Keywords: COVID-19; fetal medicine; obstetrics; public health; quality in health care.

Publication types

Multicenter Study
Observational Study
Research Support, Non-U.S. Gov't

MeSH terms

COVID-19 Vaccines
COVID-19*
Cesarean Section
Communicable Disease Control
Female
Humans
Infant, Newborn
Maternal Health Services*
Multicenter Studies as Topic
Observational Studies as Topic
Pandemics
Pregnancy
Premature Birth* / epidemiology
SARS-CoV-2
Stillbirth / epidemiology

Substances

COVID-19 Vaccines