{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T15:28:48Z","timestamp":1789658928766,"version":"4.0.1"},"reference-count":114,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T00:00:00Z","timestamp":1789430400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Fonds de Recherche Impulsion HES-SO","award":["127974"],"award-info":[{"award-number":["127974"]}]},{"name":"Swiss National Science Foundation","award":["PT0043_222882"],"award-info":[{"award-number":["PT0043_222882"]}],"id":[{"id":"https:\/\/ror.org\/00yjd3n13","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Most maternal and neonatal morbidity and mortality occur during childbirth and the immediate postnatal period. In high-income countries, where most births occur in maternity units, systematic monitoring of care quality is essential to improve safety and reduce preventable adverse outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To identify maternal and neonatal indicators of quality-of-care at childbirth and immediate postnatal period in high-income countries, and to assess their level of validity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This scoping review followed PRISMA-ScR guidelines. A systematic search was conducted in April 2024 (updated March 2025) in Medline, Embase, CINAHL, and Web of Science. Eligible studies included literature from high-income countries reporting quality-of-care indicators. Indicators were extracted as reported and consolidated: those with aligned definitions were clustered into standardised indicators and subsequently grouped into broader constructs reflecting key dimensions of care. Indicators were grouped into four domains (access, structure, process, and outcome) and evaluated using a structured validity scoring system. Indicators were classified as high-validity if they included a clear definition (with specified numerator and denominator) and achieved a validity score of 3 or 4 on a 0\u20134 scale.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Eighty-four studies were included. In total, 981 individual indicators were identified; 546 were clearly defined and consolidated into 214 standardised indicators and 61 indicator constructs. Most focused on outcomes (n\u2009=\u2009253, 46.3%) and processes (n\u2009=\u2009243, 44.5%), with substantial heterogeneity in definitions. Fewer indicators addressed structure (n\u2009=\u200947, 8.6%) and access (n\u2009=\u20093, 0.6%). Nearly one third of all indicators demonstrated high-validity, mainly within outcome and process domains.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec005\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This review identified a large set of quality-of-care indicators, reflecting sustained efforts to monitor care around childbirth. However, heterogeneity in definitions and variable validation limit comparability and routine use. These findings highlight the need for greater validation and standardisation of indicators, followed by the prioritisation of high-validity measures to support meaningful quality monitoring and improvement.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0350665","type":"journal-article","created":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T17:50:17Z","timestamp":1789494617000},"page":"e0350665","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Monitoring childbirth and immediate postpartum care quality: A scoping review of indicators in high-income countries"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-4387-2698","authenticated-orcid":true,"given":"M. Allison","family":"Warren","sequence":"first","affiliation":[{"name":"HES-SO University of Applied Sciences and Arts Western Switzerland","place":["Geneva, Switzerland"],"department":["Geneva School of Health Sciences"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-5955-4626","authenticated-orcid":true,"given":"Dayana","family":"Hamparsoumian","sequence":"additional","affiliation":[{"name":"HES-SO University of Applied Sciences and Arts Western Switzerland","place":["Geneva, Switzerland"],"department":["Geneva School of Health Sciences"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9654-8104","authenticated-orcid":true,"given":"Elsa","family":"Lorthe","sequence":"additional","affiliation":[{"name":"HES-SO University of Applied Sciences and Arts Western Switzerland","place":["Geneva, Switzerland"],"department":["Geneva School of Health Sciences"]},{"name":"Universit\u00e9 Paris Cit\u00e9 and Universit\u00e9 Sorbonne Paris Nord","place":["Paris, France"],"department":["Inserm, INRAE, Centre for Research in Epidemiology and Statistics"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3819-6526","authenticated-orcid":true,"given":"Gilles","family":"Cattani","sequence":"additional","affiliation":[{"name":"HES-SO University of Applied Sciences and Arts Western Switzerland","place":["Geneva, Switzerland"],"department":["Geneva School of Health Sciences"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7143-6117","authenticated-orcid":true,"given":"Francisca","family":"Barcos Munoz","sequence":"additional","affiliation":[{"name":"University Hospitals of Geneva","place":["Geneva, Switzerland"],"department":["Division of Neonatal and Pediatric Intensive Care of Women, Children and Adolescents"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9914-6496","authenticated-orcid":true,"given":"David","family":"Baud","sequence":"additional","affiliation":[{"name":"Lausanne University Hospital (CHUV) and University of Lausanne (UNIL)","place":["Lausanne, Switzerland"],"department":["Obstetric Service, Woman-Mother-Child Department"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline","family":"Daelemans","sequence":"additional","affiliation":[{"name":"University of Geneva","place":["Geneva, Switzerland"],"department":["Faculty of Medicine"]},{"name":"Geneva University Hospitals","place":["Geneva, Switzerland"],"department":["Department of the Woman, the Child and the Teenager"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pauline","family":"De Vries","sequence":"additional","affiliation":[{"name":"Lausanne University Hospital (CHUV) and University of Lausanne (UNIL)","place":["Lausanne, Switzerland"],"department":["Obstetric Service, Woman-Mother-Child Department"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuella","family":"Epiney","sequence":"additional","affiliation":[{"name":"University of Geneva","place":["Geneva, Switzerland"],"department":["Faculty of Medicine"]},{"name":"Geneva University Hospitals","place":["Geneva, Switzerland"],"department":["Department of the Woman, the Child and the Teenager"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emanuela","family":"Gerhard","sequence":"additional","affiliation":[{"name":"F\u00e9d\u00e9ration Suisse des sages-femmes","place":["Bern, Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus","family":"Hodel","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and fetal-maternal Medicine Kanton Spital","place":["Lucerne, Switzerland"]},{"name":"University of Lucerne","place":["Lucerne, Switzerland"],"department":["Health Department"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marzia","family":"Loghi","sequence":"additional","affiliation":[{"name":"ISTAT, SWC Servizio Sistema integrato salute, assistenza e previdenza","place":["Viale Liegi Roma, Italy"],"department":["DCSW Direzione Centrale per le Statistiche Sociali e il Welfare, DISD - 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