IJPDS International Journal of Population Data Science IJPDS 2399-4908 Swansea University 10.23889/ijpds.v10i4.3053 10:3:41 Maternal medicine network service provision from NHS England: development of an outcome indicator Soriano Victoria X 1 Geddes-Barton Dorothea M 2 Goldacre Raphael 3 Knight Marian 2 Henderson Ian 4 Frise Charlotte 5 Mackillop Lucy 6 7 Frise Charlotte 8 Siassakos Dimitrios 9 Sanders Julia 10 Carson Claire 1 NIHR Policy Research Unit in Maternal and Neonatal Health and Care, National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom Applied Health Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom Imperial College Healthcare NHS Trust, London, United Kingdom University of Oxford, Oxford, United Kingdom Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom Institute for Women's Health, University College London, London, United Kingdom School of Healthcare Sciences, Cardiff University, Cardiff, United Kingdom 01 06 2025 2025 8 4 3053 This work is licenced under a Creative Commons Attribution 4.0 International License. This article is available from the IJPDS website at: https://ijpds.org/article/view/3053 Objectives

NHS England Maternal Medicine Networks (MMN) serve women with new or pre-existing medical problems requiring advice and care before, during, and after pregnancy, to ensure equity of access and care. We describe development of an outcome indicator to evaluate the impact of MMN services using routinely collected hospital data.

 Methods

MMN regional service specifications were harmonised and category B-C medical conditions that matched in all specifications were identified. We created an indicator of modifiable severe morbidity outcomes (MSMOI) as a subset of the English Maternal Morbidity Outcome Indicator (EMMOI). The MSMOI included outcomes that could be caused or worsened by matched conditions, and are considered modifiable with MNN care. MSMOI is presented as a percentage of all outcomes in the EMMOI. Stakeholders and PPI were consulted throughout. We used English hospital admitted patient care data (HES-APC) to create a cohort of all birth episodes from 2013-2022.

 Results

Of the 170 medical conditions where maternal medicine centre support is advised, 71 match across the 17 service specifications (for 16 regions) and were used to create the MSMOI. EMMOI incidence was 3.1% (n=181,143/5,824,984), of which 85.3% (n=154,586/181,143) was considered modifiable (MSMOI). The incidence of both EMMOI and MSMOI increased markedly between 2013-2022, from 1.7% to 4.4% and 76.3% to 90.4% respectively (p<0.001).

Women <20 or >40 years old (both 3.4%), Black ethnicity (4.6%), or the most deprived (3.3%) have the highest incidence of EMMOI. The highest MSMOI proportion was among under 20-year-olds (90.9%), Asian ethnicity (88.5%), and the most deprived (87.4%). The lowest incidence of EMMOI and MSMOI is in 35-40 years olds (3.0%, 82.4%), White ethnicity (2.9%, 84.3%), and least deprived (2.7%, 81.5%).

 Conclusion

Both EMMOI and MSMOI increased in the years prior to MMN establishment in 2021. This provides baseline data with which to compare future outcomes. Consistency in eligibility criteria is key to continually evaluate MMN outputs and ensure adequate resources are provided to high-risk, expectant mothers.