National Perinatal Information Center
National Perinatal Information Center


The Adverse Outcome Index (AOI) Analysis is designed to measure the volume and magnitude of 10 adverse events which may occur during labor and delivery, potentially having a serious impact on the family and exposing providers and hospitals to malpractice liability. The events are definable and possibly modifiable through improved team training and communication

The ten types of adverse events
  • In-Hospital Maternal Death
  • In-Hospital Neonatal Death ≥ 2500 Grams and ≥ 37 Weeks Gestation
  • Uterine Rupture During Labor
  • Maternal Intensive Care
  • Birth Trauma
  • Unanticipated Operative Procedure
  • Admission to NICU of Neonate ≥ 2500 Grams and ≥ 37 Weeks GA for > 1 Day
  • APGAR 5 < 7
  • Maternal Blood Transfusion
  • 4th Degree Perineal Laceration
Each type of event has a severity weight associated with it, and there are three indices calculated from the count and weight of the events occurring at a facility.

The Adverse Outcome Index (AOI)
Weighted Adverse Outcome Score (WAOS)
Severity Index (SI)


For Member Hospitals - Available as an add-on report to the Comparative Quarterly Report Package

For insurers, perinatal collaboratives, and researchers - Customized quality reports to monitor perinatal outcomes and meet project requirements. Reports can be developed for quarterly monitoring, or measure pre and post quality improvement.

Quarterly Monitoring
  • Up to 16 quarters of data
  • AOI trend analysis
  • Comparison benchmarks to NPIC AOI
  • Target benchmark reflecting the top WAOS quartile performers
Pre-Post Quality Improvement
  • Designed for quality improvement organizations, researchers, hospitals, or hospital systems implementing quality improvement projects
  • Measures AOI improvement from a baseline to follow-up period (e.g., post team training).
An efficient and cost-effective way to monitor quality improvement.

AOI "Best Practices" Webinar
NPIC member hospitals share how they're using the AOI to reduce harm.» Learn More

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