Interventions, outcomes and outcome measurement instruments in
stillbirth care research: A systematic review to inform the development
of a core outcome set
Abstract
Background A core outcome set could address inconsistent outcome
reporting and improve evidence for stillbirth care research, which has
been identified as an important research priority. Objectives To
identify outcomes and outcome measurement instruments reported by
studies evaluating interventions after the diagnosis of a stillbirth.
Search strategy Amed, BNI, CINAHL, ClinicalTrials.gov, Cochrane Central
Register of Controlled Trials, Cochrane Database of Systematic Reviews,
Embase, MEDLINE, PsycINFO, and WHO ICTRP from 1998 to August 2021.
Selection criteria Randomised and non-randomised comparative or
non-comparative studies reporting a stillbirth care intervention. Data
collection and analysis Interventions, outcomes reported, definitions
and outcome measurement tools were extracted. Main results 40 randomised
and 200 non-randomised studies were included. 58 different interventions
were reported, labour and birth care (52 studies), hospital bereavement
care (28 studies), clinical investigations (116 studies), care in a
multiple pregnancy (2 studies), psychosocial support (28 studies) and
care in a subsequent pregnancy (14 studies). 391 unique outcomes were
reported and organised into 14 outcome domains: labour and birth;
postpartum; delivery of care; investigations; multiple pregnancy; mental
health; emotional functioning; grief and bereavement; social
functioning; relationship; whole person; subsequent pregnancy;
subsequent children and siblings and economic. 242 outcome measurement
instruments were used, with 0-22 tools per outcome. Conclusions
Heterogeneity in outcome reporting, outcome definition and measurement
tools in care after stillbirth exists. Considerable research gaps on
specific intervention types in stillbirth care were identified. A core
outcome set is needed to standardise outcome collection and reporting
for stillbirth care research.