Severe maternal morbidity and maternal near miss in the extremes of reproductive age: results from a national cross- sectional multicenter study

Abstract Purpose To evaluate the impact of the presence of criteria for severe maternal morbidity and maternal near miss associated with hypertensive disorders on maternal and perinatal outcomes in a maternity school. Methods The present is a sub-analysis of a larger study involving 27 centers in Brazil that estimated the prevalence of serious maternal morbidity and near miss. It is an analytical and cross-sectional study with a quantitative approach, involving 928 women who were cared for at Maternidade Escola Assis Chateaubriand (MEAC, in Portuguese), Universidade Federal do Ceará (UFC, in Portuguese), from July 2009 to June 2010. The women were diagnosed with near miss according to the World Health Organization (WHO) criteria. The sample was divided into 2 groups: patients with (n = 827) and without hypertension (n = 101). The results were considered statistically significant when p < 0.05. The Pearson chi-squared and Fisher Exact tests were used for the categorical variables, and the Mann–Whitney U test was used for the continuous variables. Results In total, 51 participants with maternal near miss criteria were identified, and 36 of them had hypertensive disorders. Of these, 5 died and were obviously excluded from the near miss final group. In contrast, we observed 867 cases with non-near miss maternal morbidity criteria. During this period, there were 4,617 live births (LBs) in the institution that was studied. Conclusion In the severe morbidity/maternal near miss population, the presence of hypertensive complications was prevalent, constituting a risk factor for both the mother and the fetus.

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Monitoring Maternal Near Miss/Severe Maternal Morbidity: A Systematic Review

SSRN Electronic Journal ◽

10.2139/ssrn.3444404 ◽

2019 ◽

Author(s):

Natalie England ◽

Julia Madill ◽

Amy Metcalfe ◽

Laura Magee ◽

Stephanie Cooper ◽

...

Keyword(s):

Systematic Review ◽

Maternal Morbidity ◽

Near Miss ◽

Severe Maternal Morbidity ◽

Maternal Near Miss

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Magnitude of Severe Acute Maternal Morbidity and Associated Factors Related to Abortion: A Cross-Sectional Study in Hawassa University Comprehensive Specialized Hospital, Ethiopia, 2019

BioMed Research International ◽

10.1155/2020/1781652 ◽

2020 ◽

Vol 2020 ◽

pp. 1-10

Author(s):

Mequanent Tariku

Keyword(s):

Maternal Morbidity ◽

Cross Sectional Study ◽

Near Miss ◽

World Health ◽

Maternal Near Miss ◽

Delayed Presentation ◽

Cross Sectional ◽

Severe Acute Maternal Morbidity ◽

Specialized Hospital ◽

Hawassa University

Background. Abortion-related mortality is decreasing, but the complication is still causing a significant morbidity to mothers especially in developing countries. Recently, suitable criteria to assess maternal near miss for sub-Saharan countries were adapted in harmony with the previous World Health Organization near-miss criteria. The aim of this study was to assess the magnitude of severe acute maternal morbidity and associated factors related to abortion in Hawassa University Comprehensive Specialized Hospital, Ethiopia. Method. An institution-based cross-sectional study was conducted among 337 women who sought abortion services at Hawassa University Comprehensive Specialized Hospital from January 1 to October 30, 2019. The participants were selected conveniently. Data was collected by using prospective morbidity methodology with pretested anonymous structured English questionnaire. The collected data were then entered into SPSS version 20 for analysis. Variables with p value ≤ 0.2 in the bivariate analysis, not collinear, were entered to multivariable regression. The strength of association is presented by odds ratio and 95% confidence interval. p value less than 0.05 was used as a cut-off point to determine statistically significant association. Results. The magnitude of severe acute maternal morbidity and maternal near miss is found to be 35.6 and 17.7%, respectively. Factors significantly associated with severe acute maternal morbidity were as follows: women uneducated (AOR: 3.02; 95% CI 1.24-7.33), second-trimester pregnancy (1.89-9.14), and delayed presentation (AOR: 4.32, 95% CI 1.76-10.59). Conclusion. Severe acute maternal morbidity and maternal near miss related to abortion are high despite the availability of safe termination. Near-miss cases could be better traced by using reasonably adapted World Health Organization near-miss criteria for sub-Saharan countries. Lack of education, increased gestational age, and delayed presentation had increased severe acute maternal morbidity associated with abortion which may need further education on health care seeking culture of the community.

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Use of Intensive Care Unit in Women with Severe Maternal Morbidity and Maternal Death: Results from a National Multicenter Study

Revista Brasileira de Ginecologia e Obstetrícia / RBGO Gynecology and Obstetrics ◽

10.1055/s-0040-1708095 ◽

2020 ◽

Vol 42 (03) ◽

pp. 124-132

Author(s):

Fabiano M. Soares ◽

José Paulo Guida ◽

Rodolfo Carvalho Pacagnella ◽

João Paulo Souza ◽

Mary Ângela Parpinelli ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Maternal Death ◽

Maternal Morbidity ◽

Secondary Analysis ◽

Individual Characteristics ◽

Near Miss ◽

Severe Maternal Morbidity ◽

Cross Sectional ◽

Inadequate Care

Abstract Objective To assess the use of the intensive care unit (ICU) and its effect on maternal mortality (MM) among women with severe maternal morbidity (SMM). Materials and Methods A secondary analysis of a cross-sectional study on surveillance of SMM in 27 Brazilian obstetric referral centers. The analysis focused on the association between ICU use and maternal death according to individual characteristics and disease severity. Two multivariate regressions considering use of the ICU, age, ethnicity, adequacy of care and the human development index were performed to identify the factors associated to maternal death and maternal near-miss. Results Out of 82,388 deliveries during the period, there were 9,555 (11.6%) women with SMM, and the MM ratio was of 170.4/100 thousand live births. In total, 8,135 (85.1%) patients were managed in facilities in which ICUs were available; however, only 2,059 (25.3%) had been admitted to the ICU. On the multivariate analysis, when the severity of the maternal disease was measured by the maternal severity score (MMS), the strength of the association between the use of the ICU and maternal death was greatly reduced, along with inadequate care and non-availability of the ICU at the facility. On the assessment of only the more critical cases (SMO, severe maternal outcome), the same pattern of association between ICU and MM was observed. In the models used, only inadequate care and MSS were significantly associated with MM. Conclusion The current study indicates that the main variables associated with maternal death are the severity and adequacy of the case management, which is more frequent in ICU admissions. The use of the ICU without the stratification of the patients by severity may not produce the expected benefits for part of the women.

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The WHO Maternal Near-Miss Approach and the Maternal Severity Index Model (MSI): Tools for Assessing the Management of Severe Maternal Morbidity

PLoS ONE ◽

10.1371/journal.pone.0044129 ◽

2012 ◽

Vol 7 (8) ◽

pp. e44129 ◽

Cited By ~ 85

Author(s):

Joao Paulo Souza ◽

Jose Guilherme Cecatti ◽

Samira M. Haddad ◽

Mary Angela Parpinelli ◽

Maria Laura Costa ◽

...

Keyword(s):

Maternal Morbidity ◽

Severity Index ◽

Near Miss ◽

Severe Maternal Morbidity ◽

Maternal Near Miss ◽

Index Model

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The prevalence of neonatal near miss and associated factors in Nepal: A cross-sectional study

10.21203/rs.3.rs-42794/v1 ◽

2020 ◽

Author(s):

Sushma Rajbanshi ◽

Norhayati Mohd Noor ◽

Nik Hazlina Nik Hussain

Keyword(s):

Caesarean Section ◽

Maternal Morbidity ◽

Newborn Infants ◽

Cross Sectional Study ◽

Near Miss ◽

Infant Mortality Rate ◽

Severe Maternal Morbidity ◽

Sectional Study ◽

Cross Sectional ◽

Neonatal Near Miss

Abstract Background: Unlike the infant mortality rate, the rate of neonatal mortality has not declined and remains a major health challenge in low- and middle-income countries. There is an urgent need to focus on newborn care, especially during the first 24 hours of birth and the early neonatal period. Determining which factors contribute to neonatal near miss (NNM) can be used to assess health care quality and identify factors capable of correction in the healthcare system to improve neonatal care. Thus, the objective of the current study was to establish the prevalence of NNM and identify its associated factors.Methods: A hospital-based cross-sectional study was conducted at Koshi Hospital, Nepal. Neonates and their mothers (unspecified maternal age and number of gestational weeks) were enrolled. The key inclusion criterion was the admission of newborn infants to the neonatal intensive care unit at Koshi Hospital. Non-Nepali citizens were excluded. Consecutive sampling was used until the required sample size (i.e., 1,000 newborn infants) was reached. Simple and multiple logistic regression analysis was performed using SPSS ® version 24.0.Results: One thousand respondents were recruited. The prevalence of NNM was 79 per 1,000 live births. Maternal secondary (adjusted odds ratio (AOR]: 0.46, 95% confidence interval (CI]: 0.24–0.88) and tertiary education (AOR: 0.18, 95% CI: 0.05–0.56), multiparity (AOR: 0.52, 95% CI: 0.39–0.86), Caesarean section (AOR: 0.48, 95% CI: 0.19–0.99), and severe maternal morbidity (AOR: 4.51, 95% CI: 2.07–9.84) were significantly associated with NNM.Conclusions: Parity, severe maternal morbidity, mode of delivery, and maternal education were significantly associated with NNM. Healthcare workers should be aware of the impact of obstetric factors so that earlier interventions, especially the Caesarean section, can be exercised.

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