Menu
Menu
Menu
Menu
Background The World Health Organization’s “Coordinated Global Research Roadmap: 2019 Novel Coronavirus”outlined the need for research that focuses on the impact of COVID-19 on pregnant women and children. More than one year after the first reported case significant knowledge gaps remain, highlighting the need for a coordinated approach. To address this need, the Maternal, Newborn and Child Health Working Group (MNCH WG) of the COVID- 19 Clinical Research Coalition conducted an international survey to identify global research priorities for COVID-19 in maternal, reproductive and child health. Method This project was undertaken using a modified Delphi method. An electronic questionnaire was disseminated to clinicians and researchers in three different languages (English, French and Spanish) via MNCH WG affiliated networks. Respondents were asked to select the five most urgent research priorities among a list of 17 identified by the MNCH WG. Analysis of questionnaire data was undertaken to identify key similarities and differences among respondents according to questionnaire language, location and specialty. Following elimination of the seven lowest ranking priorities, the questionnaire was recirculated to the original pool of respondents. Thematic analysis of final questionnaire data was undertaken by the MNCH WG from which four priority research themes emerged. Results Questionnaire 1 was completed by 225 respondents from 29 countries. Questionnaire 2 was returned by 49 respondents. The four priority research themes which emerged from the analysis were 1) access to healthcare during the COVID-19 pandemic, 2) the direct and 3) indirect effects of COVID-19 on pregnant and breastfeeding women and children and 4) the transmission of COVID-19 and protection from infection. Conclusion The results of these questionnaires indicated a high level of concordance among continents and specialties regarding priority research themes. This prioritized list of research uncertainties, developed to specifically highlight the most urgent clinical needs as perceived by healthcare professionals and researchers, could help funding organizations and researchers to answer the most pressing questions for clinicians and public health professionals during the pandemic. It is hoped that these identified priority research themes can help focus the discussion regarding the allocation of limited resources to enhance COVID-19 research in MNCH globally.
This project was undertaken between October 2020 and January 2021 using a modified Delphi method (Fig 1). A short online questionnaire was designed by the MNCH WG through collaborative discussions guided by the WHO’s “Coordinated Global Research Roadmap for the Novel Coronavirus” [2]. Questionnaire respondents were asked to provide demographic information including specialty and location, and to select the five most urgent research priorities among a list of 17 which had been generated by the MNCH WG through literature review and expert opinion (S1 File). Space was also provided within the questionnaire for respondents to include additional research priorities that were not included in the list. The questionnaire was translated from English into French and Spanish and disseminated electronically using the SurveyMonkey platform via affiliated networks of the MNCH WG members including: World Society for Pediatric Infectious Diseases (WSPID); European Society for Pediatric Infectious Diseases (ESPID); African Society for Pediatric Infectious Diseases (AfSPID), who forwarded to their respective in-country pediatric and obstetric associations; Honduran Pediatric Association; Royal College of Obstetricians and Gynaecologists (RCOG) and Royal College of Paediatrics and Child Health (RCPCH), who forwarded to their global health membership; American College of Obstetricians and Gynecologists (ACOG) and International Federation of Gynecology and Obstetrics (FIGO), who also forwarded to all its country member organizations for further dissemination [10–16]. We also disseminated the Questionnaire 1 via the social media platforms Twitter and Facebook [17, 18]. Responses were collected electronically over a period of four weeks and data analysis was performed using Microsoft Excel. The frequency of selection of each research priority was calculated (with each research priority being equally weighted). Subgroup analysis of Questionnaire 1 data was performed to determine the frequency of selection of each research priority according to questionnaire language, respondent specialty and respondent location (continent). An overview of additional research priorities submitted by respondents was also undertaken by the MNCH WG to determine whether they were sufficiently distinct from the original listed priorities (no new priorities were added). Following this review, the seven least frequently selected research priorities by questionnaire respondents among the original list of 17 (as indicated by the seven lowest scores) were eliminated from the list, leaving ten research priorities which were reviewed and refined by the MNCH WG and recirculated to respondents to Questionnaire 1 who had consented to being recontacted (S2 File). Respondents were asked to rank these ten research priorities from most to least important (with 1 signifying the most important priority and 10 signifying the least important priority) and to comment on the relevance and comprehensibility of the research priorities. Responses to Questionnaire 2 were also collected over a period of four weeks. The mean ranking of each research priority was calculated by dividing the sum of the rankings for each research priority by the total number of respondents to Questionnaire 2. We subsequently performed a thematic analysis of the most frequently selected priorities from Questionnaire 1 and the highest ranked priorities among the responses to Questionnaire 2, through which four principal research priority themes emerged. The MNCH WG reconvened to define important research questions within each theme. Three key questions within each research priority theme were developed following literature review to identify persisting knowledge gaps. We then presented the research questions to OBGYN and pediatric specialists at virtual international meetings to ensure agreement among specialists within the field. This project was reviewed by the Public Health England Research Ethics and Governance Group. Given the consultative nature of the surveys, the project was deemed not to require full ethical review and was granted an exemption from the ethical approval process (https://www.gov.uk/government/organisations/public-health-england/about/research).
