Are current measures of neonatal birth trauma valid indicators of quality of care?

Abstract

Birth traumas are an important cause of neonatal morbidity; however, current measures of birth injury lack precision and reliability, and therefore are not valid indicators of the quality of obstetric care. Although these limitations may raise the question of whether birth trauma rate can ever be a valid indicator of quality of care, it seems clear that many neonatal birth traumas are preventable and that the rate of specific injuries can serve as an important tool to measure care and influence practice. We hope that a better understanding and increased awareness of these limitations will bring different stakeholders together to develop a valid measure of care quality, which will reduce the incidence of preventable birth traumas. This effort will require research resources and collaboration between obstetricians, pediatricians and quality-improvement experts.