Project title: Italian Obstetric Surveillance System (ItOSS)

Duration of the project2012 – current


Main Topic

ItOSS collects and disseminates the information on maternal mortality and severe maternal morbidity in Italy. Recognised by the national decree on registries and  surveillance systems of national interest of 3rd March 2017, the ItOSS maternal mortality surveillance system includes 13 Italian Regions (Piedmont, Lombardy, Friuli Venezia Giulia, Veneto, Emilia-Romagna, Tuscany, Latium, Marche, Campania, Apulia, Calabria, Sicily and Sardinia), covering 91% of total national births.



The ItOSS provides reliable and accurate estimates of maternal mortality,  identifies its main causes and promotes research and public health interventions aimed at improving the quality of care in the maternity services and preventing avoidable maternal deaths.

The ItOSS deals with different areas of maternal and perinatal  health that include:

  • multiregional population based studies on severe acute maternal morbidity, aimed at improving treatment, integrated care pathways and maternal outcomes;
  • a pilot project on perinatal mortality surveillance aimed at estimating a reliable rate and describing the causes of perinatal deaths in three Italian regions (Lombardy, Tuscany and Sicily);

international collaboration in the framework of the International Network of Obstetric Survey Systems (INOSS) conducting multinational studies on rare conditions that cause severe maternal morbidity.


Type of study

Observational (cross sectional and case-control) studies. Maternal mortality is estimated through linkage procedures between death registry and hospital discharge database.

Maternal and perinatal mortality surveillance systems are based  on incident case reporting and include confidential enquiries.


Title of WP or Activity on inequalities

Data from the ItOSS allow the overtime monitoring of the effect of health inequalities in terms of socio-demographic characteristics, health related risk factors, geographical area of residence and health services organization on maternal and  neonatal health.



Responsible of the project: Serena Donati (

Responsible of the WP/Activity on inequalities: Serena Donati (, Alice Maraschini (, Ilaria Lega (, Paola D’Aloja (

Department/Center: National Centre for Disease Prevention and Health Promotion

Project website: