Objective To investigate the alignment between complaints, litigation cases, and significant untoward incidents (SUIs) at the Coombe Hospital, Dublin, following the release of Ireland’s national maternity strategy in 2016. Design A retrospective cohort study comparing complaints, litigation cases, and SUIs using statistical analysis. Setting Coombe Hospital, Dublin, Ireland. Sample The study analysed 1037 written complaints, 104 formal litigation cases, and 124 SUI reports from the hospital between 2016 and 2023. Methods Data were collected from the Quality Patient Safety Department at the Coombe Hospital, anonymized, and categorized using a hybrid system based on the Health Service Executive charter and Coombe Hospital’s complaint system. Complaints with multiple issues were assigned multiple codes. Statistical analysis was performed using SPSS software, and data visualization was completed with R’s ggplot2 library. A Chi-squared test (χ 2) was used to compare the data categories. Main Outcome Measures Identification of statistical relationships between complaints, litigation cases, and SUIs. Results There were significant differences between complaints and litigation cases (χ 2 = 221.4, p < 0.001) and between complaints and SUIs (χ 2 = 263.1, p < 0.001). However, there was no significant difference between litigation cases and SUIs (χ 2 = 4.0, p = 0.14), suggesting that similar issues trigger both legal action and classification as SUIs. Conclusions Investment in the SUI system is crucial for fostering a culture of continuous learning in maternity care. Insights from SUIs can help identify areas for improvement and potentially reduce litigation by enhancing patient safety.

Background The global effect of the COVID-19 pandemic has had an impact on pregnancy and outcomes. There has been recently some conflicting evidence on the stillbirths during the COVID-19 pandemic. This meta-analysis attempts to resolve this through a systematic approach. Objectives To analyse and determine the impact of COVID-19 on the stillbirth rate. Search strategy We searched PubMed, Embase, Cochrane library, ClinicalTrials.gov and Web of Science from inception to 05 March 2021 with no language restriction for this meta-analysis. Selection criteria Publications (a) with stillbirth data on pregnant women with COVID-19 (b) comparing stillbirth rates in pregnant women with and without COVID-19 and (c), comparing stillbirth rates before and during the pandemic. Data collection and Analysis The included studies were all observational studies, and we used the Newcastle Ottawa score for risk of bias. We performed the meta-analysis using Comprehensive meta-analysis software, version 3. Main results A total of 29 studies were included in the meta-analysis; from 17 of these, the SB rate was 7 per 1000 in pregnant women with COVID-19. This rate was much higher (34/1000) in low- and middle-income countries. The odds ratio of stillbirth in pregnant women with COVID-19 compared to those without was 1.89. However, there was no significant difference in population SB rates before and during the pandemic. Conclusions There is some evidence that the stillbirth rate has increased during the COVID-19 pandemic, but this is mainly in low- and middle-income countries. Inadequate access to healthcare during the pandemic could be a contributing factor.

Anxiety and Depression Scores in Maternity Healthcare Workers during the Covid-19 PandemicGillian A. Corbett1, Sarah J. Milne1, Suruchi Mohan2, Shuja Reagu3, Stephen W. Lindow1, Mark P. Hehir1, Michael P O’connell1.