Premier, Inc., a leading technology-driven healthcare improvement company, announced the publication of a new study in The Lancet Regional Health – Americas. The study introduces the maternal Prenatal Risk Index (m-PRI), a precise, mortality-informed framework for identifying patients at risk for severe maternal morbidity (SMM).
Developed in collaboration with the U.S. Department of Health and Human Services (HHS) Office on Women’s Health (OWH), the study analyzed 7,174,412 inpatient delivery hospitalizations from 2016 to 2023 across 864 hospitals in 49 states. The research builds on the HHS Perinatal Improvement Collaborative (PIC), a national initiative overseen by OWH that uses Premier’s real-time data, analytics and performance improvement methodologies to connect more than 250 hospitals nationwide. The PIC leverages standardized data to evaluate clinical practices and help improve maternal and infant outcomes.
The new study utilized Premier’s comprehensive Premier Healthcare Database (PHD), a diverse, all-payer administrative database representing approximately 25 percent of annual inpatient encounters across more than 1,400 hospitals in the United States. Combined with Premier’s data science expertise, the PHD provides detailed insights into patient demographics, disease states, medications, laboratory tests, diagnostic procedures and hospital characteristics, helping researchers build a more precise and clinically actionable maternal risk model.
Unlike traditional approaches that treat all severe maternal morbidity events equally, the m-PRI weights prenatal risk factors based on how strongly they are associated with mortality-informed SMM severity. This creates a more nuanced and clinically actionable approach to maternal risk assessment.
“One of the biggest gaps in maternal health has been consistency in how we define risk, how we measure it and how we act on it,” said Angela Lanning, Chief Operating Officer of Healthcare Informatics and Technology Services at Premier. “This new index creates a common, data-driven standard, giving providers the insight to know not just whether risk exists but how severe that risk may be. The U.S. has some of the highest maternal complication rates in the developed world. This added level of insight helps clinicians make more informed care decisions, support earlier intervention and improve outcomes for mothers and infants.”
Researchers evaluated 46 potential maternal risk factors and incorporated 28 clinically relevant conditions into the final model. Among the more than seven million deliveries studied, 56,612 patients experienced at least one SMM event. Conditions such as placenta accreta spectrum, chronic renal disease and acquired cardiac disease showed the strongest associations with greater SMM severity.
Compared with the existing Obstetric Comorbidity Scoring System (OCSS), the m-PRI demonstrated stronger predictive performance across maternal age, demographics and payer groups. Notably, 97 percent of patients who experienced SMM had a nonzero m-PRI score, indicating improved identification of high-risk patients.
“For too long, we’ve treated complications in pregnancy after they happen,” said David Zito, President of Performance Services at Premier. “This index is about getting ahead of risk more quickly and with clearer insight into who most needs intervention.
“If you want healthier mothers and babies, you don’t start in the delivery room — you start upstream,” Zito said. “This index helps us see risk before it becomes a crisis while also creating a standardized foundation for how to improve care at scale and bend the curve on maternal outcomes.”
The m-PRI offers providers a stronger framework for both prospective identification of patients at high risk during pregnancy and retrospective analysis to identify hidden gaps in maternal healthcare delivery. It also supports broader maternal health policy and quality improvement efforts by creating a more consistent, patient-centered approach to maternal risk assessment.
The study reflects Premier’s continued commitment to helping health systems use data, technology and performance improvement strategies to drive measurable clinical outcomes and advance maternal health nationwide.
Learn more about the study and its findings here.
About Premier, Inc.
Premier, Inc. is a leading technology-driven healthcare improvement company. Playing a critical role in the rapidly evolving healthcare industry, Premier unites providers, suppliers, and payers to make healthcare better with national scale, smarter with actionable intelligence, and faster with novel technologies. Headquartered in Charlotte, N.C., Premier offers integrated data and analytics, collaboratives, supply chain solutions, advisory services, and other solutions in service of our mission to improve the health of communities. Please visit Premier’s news site at www.premierinc.com; as well as X, Facebook, LinkedIn, YouTube, Instagram, and Premier’s blog for more information about the Company.
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