Factors associated with maternal near-miss morbidity and mortality in Kowloon Hospital, Suzhou, China

Background. Life-threatening situations might arise unexpectedly during pregnancy. Maternal near-miss can be a proxy for maternal death and explained as women who nearly died due to obstetric-related complications. It is recognized as the predictor of level of care and maternal death. Maternal near-miss evaluates life-threatening pregnancy-related complications, and it directs the assessment of the quality of obstetric care. Objective. To determine the proportion and factors associated with maternal near-miss at maternity wards at the University of Gondar Referral Hospital, Northwest Ethiopia, 2019. Methods. A cross-sectional study design was carried out from March 1 to June 20, 2019, using WHO criteria for maternal near-miss at the University of Gondar Referral Hospital. The data are from the interviews and review of 303 systematically selected participants’ medical files at maternity wards. Bivariate and multivariable logistic regression analyses were performed to analyze factors associated with maternal near-miss, including estimation of crude and adjusted odds ratios and their respective 95% confidence intervals and p value less than 0.05 through SPSS version 20. Result. The study revealed that the proportion of maternal near-miss was found to be 15.8% (95%CI=11.9%-20.1%). In the adjusted analyses, maternal near-miss was significantly associated with low (≤1000 ETB) monthly income (AOR=399; 95%CI=1.65, 9.65), seven or more days of hospital stay (AOR=5.43; 95%CI=2.49, 11.83), vaginal bleeding (AOR=2.75, 95%CI=1.17, 6.47), and pregnancy-induced hypertension (AOR=5.13; 95%CI=2.08, 12.6). Conclusion and Recommendation. The near-miss proportion was comparable to that in the region. Associated factors were low monthly income, seven or more days of hospital stay, vaginal bleeding, and pregnancy-induced hypertension. Thus, giving attention on early identification and treatment of these potential factors can be the opportunity in the reduction of maternal morbidity and mortality.

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Factors associated with maternal near miss in childbirth and the postpartum period: findings from the birth in Brazil National Survey, 2011–2012

Reproductive Health ◽

10.1186/s12978-016-0232-y ◽

2016 ◽

Vol 13 (S3) ◽

Cited By ~ 18

Author(s):

Rosa Maria Soares Madeira Domingues ◽

Marcos Augusto Bastos Dias ◽

Arthur Orlando Corrêa Schilithz ◽

Maria do Carmo Leal

Keyword(s):

National Survey ◽

Postpartum Period ◽

Near Miss ◽

Maternal Near Miss ◽

Factors Associated

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Factors Associated With Severe Maternal Outcomes at a Regional Referral Hospital in South-Western Uganda: A Case-Control Study

International Journal of Women’s Health Care ◽

10.33140/ijwhc.05.01.03 ◽

2020 ◽

Vol 5 (1) ◽

Keyword(s):

Maternal Outcome ◽

Referral Hospital ◽

Near Miss ◽

Maternal Near Miss ◽

Maternal Outcomes ◽

Regional Referral Hospital ◽

Live Births ◽

Factors Associated ◽

Severe Maternal Outcome ◽

Mortality Ratio

Background: The Sustainable Development Goal target is to reduce the global maternal mortality ratio to less than 70 per 100,000 live births by 2030. Maternal morbidity and mortality in sub-Saharan Africa remains high despite global efforts to reduce it. Severe maternal outcome studies offer a panoramic assessment of obstetric care. Objective: The study aimed at determining the factors associated with severe maternal outcomes among women admitted at the obstetrics and gynecology ward of Mbarara Regional Referral Hospital. Methods: In an unmatched case control (1:2) study conducted between February and May 2018, 162 pregnant women admitted on the obstetrics and gynecology ward of Mbarara Regional Referral Hospital, or who had delivered within the past 42 days were recruited. Near miss cases were defined based on the WHO criteria. Near-miss cases and events, maternal deaths and their causes were retrospectively reviewed. Three categories of risk factors (socio-demographic, obstetric and health system) were examined. P-values <0.05 were considered statistically significant. A multivariable logistic regression model was used to identify factors associated with severe maternal outcomes. All analyses were performed using Stata software (Version 12.0, StataCorp, and College Station, TX). Results: In the four-month period there were 2301 live births, there were 45 near miss cases and 9 maternal deaths resulting in a severe maternal outcome ratio of 23.5/1000 live births, maternal near miss ratio of 19.6/1,000 live births, maternal near-miss mortality ratio of 5 and mortality index of 16.7%. Severe obstetric hemorrhage (33%), ruptured uterus (27.8%), sepsis or severe systemic infection (16.7%) and hypertensive disorders in pregnancy (16.7%) were the direct causes of severe maternal outcomes. About seventy-seven percent (77.8%) of the mothers with severe maternal outcomes were referred in from the peripheral health facilities, with a 4-time risk increased risk of a severe maternal outcome (aOR, 4.00; 95 % CI, 1.84-6.66, p-<0.001). Conclusion: Of the severe maternal outcomes, direct causes were the most prevalent and most of which are preventable. Being referred in was significantly associated with severe maternal outcomes. The maternal near miss indicators indicate need for improved quality.

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Factors Associated with Maternal Near Miss among Women Admitted in West Arsi Zone Public Hospitals, Ethiopia: Unmatched Case-Control Study

Journal of Pregnancy ◽

10.1155/2020/6029160 ◽

2020 ◽

Vol 2020 ◽

pp. 1-10 ◽

Cited By ~ 1

Author(s):

Fikadu Nugusu Dessalegn ◽

Feleke Hailemichael Astawesegn ◽

Nana Chea Hankalo

Keyword(s):

Cesarean Section ◽

Antenatal Care ◽

Case Control Study ◽

Case Control ◽

Public Hospitals ◽

Near Miss ◽

Maternal Near Miss ◽

Factors Associated ◽

Arsi Zone ◽

Control Study

Background. Maternal near miss refers to a very ill pregnant or delivered woman who nearly died but survived a complication during pregnancy, childbirth, or within 42 days of termination of pregnancy. Maternal death; the most catastrophic end is frequently described as just “tip of the iceberg,” whereas maternal near-miss as the “base.” Therefore, this study aimed at assessing the factors associated with maternal near-miss among women admitted in public hospitals of West Arsi zone, Ethiopia. Methods. A facility-based unmatched case-control study was conducted from Mar 1 to Apr 30, 2019. Three hundred twenty-one (80 cases and 241 controls) study participants were involved in the study. Cases were recruited consecutively as they present, whereas controls were selected by systematic sampling method. Cases were women admitted to hospitals during pregnancy, delivery, or within 42 days of termination of pregnancy and fulfilled at least one of the maternal near-miss disease-specific criteria, while controls were women admitted and gave birth by normal vaginal delivery. The interviewer-administered structured questionnaire and data abstraction tool was used to collect data. Data were entered Epi data 3.1 and then transferred into SPSS 20 for analysis. Multivariable logistic regression was used, and the significance level was declared at p value ≤ 0.05. Results. The major maternal near-miss morbidities were severe obstetric hemorrhage (32.5%), pregnancy-induced hypertensive disorders (31.3%), and obstructed labor (26.3%), followed by 6.3% and 3.8% of severe anemia and pregnancy-induced sepsis, respectively. The odds of maternal near miss were statistically significantly associated with women’s lack of formal education [AOR=2.24, 95% CI: (1.17, 4.31)]. Not attending antenatal care [AOR=3.71, 95% CI: (1.10, 12.76)], having prior history of cesarean section [AOR=3.53, 95% CI: (1.49, 8.36)], any preexisting chronic medical disorder [AOR=2.04, 95% CI: (1.11, 3.78)], and having experienced first delay [AOR=5.74, 95% CI: (2.93, 11.2)]. Conclusions. Maternal education, antenatal care, chronic medical disorders, previous cesarean section, and first delay of obstetric care-seeking were identified as factors associated with maternal near-miss morbidity. Therefore, this finding implies the need to get better with those factors, to preclude severe maternal complications and subsequent maternal mortality.

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