scholarly journals Skin Color and Maternal Near Miss: Exploring a Demographic and Health Survey in Brazil

2017 ◽  
Vol 39 (05) ◽  
pp. 209-216 ◽  
Author(s):  
Karayna Fernandes ◽  
Maria Sousa ◽  
José Cecatti
Keyword(s):  
Maternal Mortality ◽  
Health Survey ◽  
Skin Color ◽  
White Women ◽  
Maternal Mortality Ratio ◽  
Demographic And Health Survey ◽  
Near Miss ◽  
Maternal Near Miss ◽  
Maternal Complications ◽  
Cross Sectional

Purpose In 2013, it was estimated that 289,000 maternal deaths occurred worldwide. The maternal mortality ratio has decreased in many countries in the past decades, due to early identification and treatment of obstetric complications, despite the dissimilarities observed in diverse locations and populations. Black women, for instance, have always been more susceptible to the occurrence of maternal mortality and severe morbidity. Therefore, the objective of this study is to assess skin color as a predictive factor for maternal near miss (MNM) in a sample of Brazilian women interviewed in the Brazilian National Demographic and Health Survey (DHS) of 2006. Method A secondary analysis of the DHS database, a population-based cross-sectional nationally representative study was conducted. This database is of public domain. The risk of maternal complications according to ethnic group and the associated sociodemographic characteristics were evaluated. For the data analysis, the odds ratios and respective 95% confidence intervals were calculated. Results In the sample interviewed, 59% of women were black or brown (mixed-race). Approximately 23% of women had some complication, and 2% of these women had at least one MNM pragmatic criterion. The MNM rate was 31 per 1,000 live births, and its occurrence was not statistically different among the ethnic groups. The only factors identified that were considered to be associated with the occurrence of MNM were maternal age above 40 and women not currently attending school, but only among white women. Conclusion The 2006 DHS results did not show a higher occurrence of maternal complications, and specifically of MNM associated with black/brown skin color.

scholarly journals Skin Color and Severe Maternal Outcomes: Evidence from the Brazilian Network for Surveillance of Severe Maternal Morbidity

2019 ◽  
Vol 2019 ◽  
pp. 1-11
Author(s):  
K. G. Fernandes ◽  
M. L. Costa ◽  
S. M. Haddad ◽  
M. A. Parpinelli ◽  
M. H. Sousa ◽  
...  
Keyword(s):  
Maternal Mortality ◽  
Skin Color ◽  
Maternal Morbidity ◽  
White Women ◽  
Maternal Outcome ◽  
Near Miss ◽  
Severe Maternal Morbidity ◽  
Maternal Near Miss ◽  
Maternal Outcomes ◽  
Severe Maternal Outcome

Background. Taking into account the probable role that race/skin color may have for determining outcomes in maternal health, the objective of this study was to assess whether maternal race/skin color is a predictor of severe maternal morbidity. Methods. This is a secondary analysis of the Brazilian Network for Surveillance of Severe Maternal Morbidity, a national multicenter cross-sectional study of 27 Brazilian referral maternity hospitals. A prospective surveillance was performed to identify cases of maternal death (MD), maternal near miss (MNM) events, and potentially life-threatening conditions (PLTC), according to standard WHO definition and criteria. Among 9,555 women with severe maternal morbidity, data on race/skin color was available for 7,139 women, who were further divided into two groups: 4,108 nonwhite women (2,253 black and 1,855 from other races/skin color) and 3,031 white women. Indicators of severe maternal morbidity according to WHO definition are shown by skin color group. Adjusted Prevalence Ratios (PRadj - 95%CI) for Severe Maternal Outcome (SMO=MNM+MD) were estimated according to sociodemographic/obstetric characteristics, pregnancy outcomes, and perinatal results considering race. Results. Among 7,139 women with severe maternal morbidity evaluated, 90.5% were classified as PLTC, 8.5% as MNM, and 1.6% as MD. There was a significantly higher prevalence of MNM and MD among white women. MNMR (maternal near miss ratio) was 9.37 per thousand live births (LB). SMOR (severe maternal outcome ratio) was 11.08 per 1000 LB, and MMR (maternal mortality ratio) was 170.4 per 100,000 LB. Maternal mortality to maternal near miss ratio was 1 to 5.2, irrespective of maternal skin color. Hypertension, the main cause of maternal complications, affected mostly nonwhite women. Hemorrhage, the second more common cause of maternal complication, predominated among white women. Nonwhite skin color was associated with a reduced risk of SMO in multivariate analysis. Conclusion. Nonwhite skin color was associated with a lower risk for severe maternal outcomes. This result could be due to confounding factors linked to a high rate of Brazilian miscegenation.

scholarly journals Factors associated with maternal near-miss at public hospitals of South-East Ethiopia: An institutional-based cross-sectional study

2021 ◽  
Vol 17 ◽  
pp. 174550652110606
Author(s):  
Ashenafi Mekonnen ◽  
Genet Fikadu ◽  
Kenbon Seyoum ◽  
Gemechu Ganfure ◽  
Sisay Degno ◽  
...  
Keyword(s):  
Maternal Mortality ◽  
Rural Areas ◽  
Cross Sectional Study ◽  
Public Hospitals ◽  
Near Miss ◽  
Early Marriage ◽  
Maternal Near Miss ◽  
P Value ◽  
Sectional Study ◽  
Cross Sectional

Introduction: Maternal near-miss precedes maternal mortality, and women are still alive indicating that the numbers of near-misses occur more often than maternal mortality. This study aims to assess the prevalence of maternal near-miss and associated factors at public hospitals of Bale zone, Southeast Ethiopia. Methods: Facility-based cross-sectional study design was carried out from 1 October 2018 to 28 February 2019, among 300 women admitted to maternity wards. A structured questionnaire and checklist were used to collect data. Epi-info for data entry and statistical package for social science for analysis were used. The descriptive findings were summarized using tables and text. Adjusted odds ratio with 95% confidence interval and p-value < 0.05 were used to examine the association between the independent and dependent variables. Result: The prevalence of maternal near-miss in our study area was 28.7%. Age < 20 years, age at first marriage < 20 years, husbands with primary education, and being from rural areas are factors significantly associated with the prevalence of maternal near-miss. The zonal health department in collaboration with the education department and justice office has to mitigate early marriage by educating the community about the impacts of early marriage on health.

scholarly journals Obstetric near miss events and maternal deaths in a tertiary care hospital

2018 ◽  
Vol 7 (2) ◽  
pp. 519
Author(s):  
Vrinda Patil ◽  
Vidya Kamath ◽  
Rathnamala M. Desai
Keyword(s):  
Maternal Mortality ◽  
Maternal Death ◽  
Maternal Mortality Ratio ◽  
Near Miss ◽  
Maternal Near Miss ◽  
Care Hospital ◽  
Maternal Deaths ◽  
Mortality Index ◽  
Mortality Ratio ◽  
Life Threatening

Background: Maternal mortality is one of the important indicators of maternal health. Objectives of present study were to determine the frequency of maternal near miss, maternal near miss incidence ratio, maternal near miss to mortality ratio and mortality index and to study the risk factors associated with near miss events.Methods: A retrospective analysis of severe maternal morbidity from January 2015 to December 2015 was studied. Data was collected from women with pregnancy related life-threatening complications, near miss cases and maternal deaths.Results: The total number of deliveries were 5247. The numbers of maternal deaths were 12. Maternal mortality ratio was 228 per one lakh deliveries. There were 5.3 near miss events for every 1 maternal death. The nature and course of near miss cases were analysed. Severe maternal odds ratio was 14.48. Mortality index was 15.78%. Maternal near miss incidence ratio was 12.19.Conclusions: Near Miss Mortality indicator is helpful in identifying the life-threatening conditions and thus aiming to prevent maternal mortality. Hypertensive disorders and its complications are the leading causes of near miss events. Sepsis is the main cause of maternal death.

scholarly journals Maternal near miss events: a retrospective observational study in a tertiary care centre of central India

2018 ◽  
Vol 7 (6) ◽  
pp. 2142
Author(s):  
Ruchita Dadhich ◽  
Gita Guin ◽  
Sarika Rawat
Keyword(s):  
Maternal Mortality ◽  
Maternal Death ◽  
Tertiary Care ◽  
Maternal Mortality Ratio ◽  
Significant Proportion ◽  
Near Miss ◽  
Maternal Near Miss ◽  
Critically Ill Patient ◽  
Tertiary Care Centre ◽  
Severe Morbidity

Background: Clinically women who have survived complications during pregnancy and childbirth termed as Maternal Near Miss. The major reasons and causes are the same for both Maternal Near Miss and Maternal Death, so review of MNM cases is likely to yield valuable information regarding severe morbidity, which could lead to death of the mother, if not intervened properly and in time. Investigating the instances of severe morbidity may be less threatening to providers because the woman survived.Methods: It was a retrospective study conducted at the Department of Obstetrics & Gynaecology NSCB Medical College Jabalpur, Madhya Pradesh, India. Data of maternal death and maternal near miss was collected from the previous records from 1st January 2017 to December 2017 according to WHO 2009 criteria.Results: Total number of near miss cases was 164 and total number of Maternal Death was 111. Maternal Near Miss incidence ratio was 28.70 per 1000 live births. Maternal Near Miss to Maternal Mortality Ratio was 1.46 and Mortality index was 40.36%. Common cause of Near Miss events was hypertensive disorders of pregnancy - 85 cases (51.82%), followed by hemorrhage - 39 cases (23.78%). heart disease- 9 cases (5.48%) was also common during pregnancy.Conclusions: In summary, this study shows that besides 111 cases who died, there were another 164 cases who survived due to the prompt diagnosis and treatment received in our set- up However, the overall high incidence of near-miss to maternal mortality (1.46) indicates that a significant proportion of critically ill patient still die of these complications. Maternal near miss reviews will be the best tool for the betterment of community and health care systems.

scholarly journals A study to assess proportion of the maternal near miss to maternal death in a tertiary care teaching hospital of North East India

2020 ◽  
Vol 9 (6) ◽  
pp. 2486
Author(s):  
Pradip Sarkar ◽  
Jahar Lal Baidya ◽  
Ashis Kumar Rakshit
Keyword(s):  
Maternal Mortality ◽  
Maternal Death ◽  
Tertiary Care ◽  
Maternal Mortality Ratio ◽  
Near Miss ◽  
Maternal Near Miss ◽  
Maternal Deaths ◽  
Live Births ◽  
Medical Disorders ◽  
Mortality Ratio

Background: The objective of present study was to assess the proportion of maternal near miss and maternal death and the causes involved among patients attending obstetrics and gynaecology department of Agartala Govt. Medical College of North Eastern India.Methods: Potentially life-threatening conditions were diagnosed, and those cases which met WHO 2009 criteria for near miss were selected. Maternal mortality during the same period was also analyzed. Patient characteristics including age, parity, gestational age at admission, booked, mode of delivery, ICU admission, duration of ICU stay, total hospital stay and surgical intervention to save the life of mother were considered. Patients were categorized by final diagnosis with respect to hemorrhage, hypertension, sepsis, dystocia (direct causes) anemia, thrombocytopenia, and other medical disorders were considered as indirect causes contributing to maternal near miss and deaths.Results: The total number of live births during the study period (January 2017 to June, 2018) was 9378 and total maternal deaths were 37 with a maternal mortality ratio of 394.5/1 lakh live births. Total near miss cases were 96 with a maternal near miss ratio of 10.24/1000 live births. Maternal near miss to mortality ratio was 2.6. Of the 96 maternal near miss cases - importantly 20.8% were due to haemorrhage, 19.8% were due to hypertension, 13.5% were due to sepsis, and 11.5% were due to ruptured uterus. In maternal death group (n-37), most important causes were hypertensive (40.5%) followed by septicemia (21.6%), haemorrhage (10.8).Conclusions: Haemorrhage, hypertensive disorders and sepsis were the leading causes of near miss events as well as maternal deaths.

scholarly journals Evaluation of severe acute maternal morbidity and mortality at a tertiary referral center of Uttarakhand, India

2019 ◽  
Vol 8 (4) ◽  
pp. 1601
Author(s):  
Lipi Verma ◽  
Ruchira Nautiyal ◽  
Pradeep Aggarwal
Keyword(s):  
Maternal Mortality ◽  
Tertiary Care ◽  
Maternal Mortality Ratio ◽  
Cross Sectional Study ◽  
Near Miss ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Tertiary Referral Center ◽  
Live Births ◽  
Life Threatening

Background: Maternal mortality is an area of concern for the Governments across the globe. India is signatory to millennium declaration and is committed to achieving the target of millennium development goals by reducing MMR to 100. Known obstacles to reducing the MMR in developing countries, include lack of material and human resources, as well as difficulties in accessing services due to financial, geographical, and cultural limitations.Methods: It was a descriptive cross-sectional study conducted at a tertiary care centre in Uttarakhand for a period of one year. WHO’s near-miss approach was implemented for evaluation of severe maternal outcomes and to assess the quality of maternal health care.Results: During the period of this study there were 2243 total antenatal admissions, 1675 deliveries, 1591 live births and 59 near miss cases. Prevalence of SAMM in the present study is 3.52%. Out of every 9-10 women who survived a life-threatening condition 1 died. Mortality Index is 10.17%. Maternal mortality ratio is 377.12 per 1 lakh live births. A total of 43 patients with potentially life-threatening conditions were admitted in ICU out of which 26 were near miss cases. The leading cause of near miss in this tertiary health facility is obstetric haemorrhage (45.8%).Conclusions: Prompt identification of complications and timed intervention remains the key determinant in making mothers survive a life-threatening complication.

scholarly journals Near miss maternal mortality, who is responsible? Administration, healthcare system or the people themselves

2017 ◽  
Vol 6 (10) ◽  
pp. 4318 ◽  
Author(s):  
Smita Tyagi
Keyword(s):  
Maternal Mortality ◽  
Near Miss ◽  
Safe Motherhood ◽  
Maternal Near Miss ◽  
High Tech ◽  
Contributory Factor ◽  
Maternal Complications ◽  
The People ◽  
One Year ◽  
A Prospective Study

Background: The concept of maternal near miss is assumed to be a better indicator than maternal mortality alone for designing, monitoring, follow up and evaluation of safe motherhood programmes. Objective of present study was to find out the causes of near miss maternal mortality according to WHO and to prevent it.Methods: It is a prospective study of one year. Cases of maternal near miss were diagnosed and treated according to WHO definitions, which included severe maternal complications, life threatening conditions and critical interventions.Results: In present study hemorrhage (53%) was the leading cause of maternal near miss followed by hypertension (26%) rupture uterus (13%) and obstructed labour (6.6%). Anemia is the major contributory factor (93%) of near miss in present study.Conclusions: To reduce near miss cases there should be major policy changes at the administrative level, it should be well implemental at the health care level and last but not the least people should be made aware of these schemes specialty by TV. Internet and smart phones in this high tech 21st century.

scholarly journals Factors associated with maternal near-miss at Public hospitals of South-East Ethiopia: An institutional based cross-sectional study

2020 ◽  
Author(s):  
Ashenafi Mekonnen ◽  
Genet Fikadu ◽  
Kenbon Seyoum ◽  
Gemechu Ganfure ◽  
Sisay Degno ◽  
...  
Keyword(s):  
Maternal Mortality ◽  
Cross Sectional Study ◽  
Public Hospitals ◽  
Near Miss ◽  
Early Marriage ◽  
Maternal Near Miss ◽  
P Value ◽  
Sectional Study ◽  
Cross Sectional ◽  
Near Misses

Abstract Background Maternal near-miss precedes maternal mortality and women are still alive indicating that the numbers of near misses occur more often than maternal mortality. This study aims to assess the prevalence of maternal near-miss and associated factors at public hospitals of Bale zone, Southeast Ethiopia.Methods Facility-based cross-sectional study design was carried out from October 1, 2018, to February 28, 2019, among 300 women admitted to maternity wards. A structured questionnaire and checklist were used to collect data. Epi-info for data entry and statistical package for social science for analysis were used. The descriptive findings were summarized using tables and text. Adjusted odds ratio with 95% confidence interval and p-value <0.05 were used to examine the association between the independent and dependent variables.Result The prevalence of maternal near-miss in our study area was 28.7%. Being age less than 20 years, age of first marriage less than 20 years, having husband with primary school complete and being from rural residence are factors significantly associated with maternal near miss. The zonal health department in collaboration with the education department and Justice Office has to mitigate early marriage by educating the community about the impacts of early marriage on health.

scholarly journals Maternal Near Miss Morbidity and Maternal Mortality in a Tertiary Referral Center in Turkey

2017 ◽  
pp. 1
Author(s):  
Dilek Uygur ◽  
Yaprak Engin Üstün ◽  
Özgür Kara ◽  
Kudret Erkenekli ◽  
Selcen Yüksel ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Maternal Mortality ◽  
Hospital Stay ◽  
Maternal Mortality Ratio ◽  
Length Of Hospital Stay ◽  
Hemoglobin Level ◽  
Near Miss ◽  
Maternal Near Miss ◽  
Tertiary Referral ◽  
Live Births

<p><strong>Objective:</strong> The objective of the study is to present the maternal near miss and maternal mortality cases from a tertiary hospital and to evaluate the factors associated with the presence of maternal near miss.<br /><strong>Study Design:</strong> We performed a retrospective study, including all women who fulfilled the WHO criteria for maternal near miss or death between June 2009 and June 2014 at a tertiary referral education hospital. This study was conducted to evaluate the risk factors’ influence on near miss, multivariate logistic regression was used. Before setting logistic regression, univariate analyses were used to select candidate variables.<br /><strong>Results:</strong> During the 5-year study, there were 82924 deliveries and 81673 live births. We identified 202 maternal near miss events and 11 maternal deaths. The maternal near miss ratio was 2.47 per 1.000 live births and the maternal mortality ratio was 13.46 per 100.000 live births. There were 213 women with a severe maternal outcome ratio (SMOR) (near miss + maternal death), with a ratio of 2.6 cases/1.000 live birth. Near miss events were associated with length of hospital stay (p&lt;0.001), hemoglobin level (p=0.003). <br /><strong>Conclusion:</strong> By the help of the WHO near miss approach, we identified that near miss events were associated with length of hospital stay, hemoglobin level, cesarean section deliveries and parity.</p>

scholarly journals Maternal mortality according to race/skin color in Mato Grosso do Sul, Brazil, from 2010 to 2015

2017 ◽  
Vol 17 (4) ◽  
pp. 729-737 ◽  
Author(s):  
Renata Palópoli Pícoli ◽  
Luiza Helena de Oliveira Cazola ◽  
Everton Ferreira Lemos
Keyword(s):  
Black Women ◽  
Maternal Mortality ◽  
Skin Color ◽  
White Women ◽  
Maternal Mortality Ratio ◽  
The State ◽  
Indigenous Women ◽  
Mato Grosso ◽  
Mortality Ratio ◽  
Mato Grosso Do Sul

Abstract Objectives: to investigate the epidemiological profile, by race/skin color, of maternal deaths in the state of Mato Grosso do Sul, Brazil. Methods: the present epidemiological study of maternal death distribution by race/skin color was based on data extracted from Brazilian mortality and livebirth information systems from 2010 to 2015. The maternal mortality ratio and the specific maternal mortality ratio were calculated and analyzed according to obstetric variables. Results: the death risk for black (RR = 4.3, CI95%= 2.088.71) and indigenous women (RR = 3.7, CI95% 2.26.23) was approximately fourfold in comparison to the risk for white women. For direct causes of death, the state of Mato Grosso do Sul showed higher levels, 74.1%, as well as for most races/skin colors in the first triennium. The specific maternal mortality ratio was higher among black and indigenous women aged30 to 39 years old (416.7 and 651.8, respectively) per 100,000 live births (p<0.05). Conclusions: higher maternal mortality ratio for indigenous and black women and the predominance of deaths related to direct obstetric causes among race/skin color categories reflect inadequate health care during pregnancy and puerperium.

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