Distant and proximate factors associated with maternal near-miss: a nested case-control study in selected public hospitals of Addis Ababa, Ethiopia

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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Factors associated with neonatal near-miss in selected hospitals of Gamo and Gofa zones, southern Ethiopia: nested case-control study

BMC Pregnancy and Childbirth ◽

10.1186/s12884-019-2684-x ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 2

Author(s):

Abera Mersha ◽

Agegnehu Bante ◽

Shitaye Shibiru

Keyword(s):

Antenatal Care ◽

Case Control Study ◽

Case Control ◽

Near Miss ◽

Southern Ethiopia ◽

Factors Affecting ◽

Factors Associated ◽

Nested Case Control ◽

Control Study ◽

Neonatal Near Miss

Abstract Background To scale up a comprehensive way of implementation to reduce neonatal mortality evaluation of factors for neonatal near-miss cases is very important. Certain studies were done in assessing near-miss cases, but they failed in identifying the proximate factors affecting profoundly. So, this study is to fill those gaps in the aforementioned studies, in assessing the factors affecting neonatal near-miss cases. Methods A nested case-control study was conducted in selected three Hospitals of Gamo and Gofa Zones, Southern Ethiopia from April 5, 2018, to March 5, 2019. The structured standard tool was used to identify neonatal near-miss cases. Data were entered into Epi data version 3.1 and exported to Stata version 15 for analysis. A conditional logistic regression model was used to identify factors associated with near-miss cases. The goodness of fit was tested by a log-likelihood ratio (LR). In this study P-value < 0.05 was considered to declare a result as a statistically significant association. Results In this study 121 neonatal near-miss cases, and 363 controls were involved. The identified factors that affect neonatal near-miss were multiparty (AOR = 3.81, 95%CI: 1.72, 8.42), antenatal care follow up (AOR = 0.02, 95%CI: 0.01, 0.05), premature rupture of membrane (AOR = 3.40, 95%CI: 1.53, 7.55), non-vertex presentation (AOR = 2.83, 95%CI: 1.44, 5.58), and cesarean delivery (AOR = 4.89, 95%CI: 2.34, 10.24). Conclusions Those identified factors are better should be intervened. Strengthening antenatal care services by providing appropriate information for the mother and counseling about the consequences of multiparty and providing information on family planning. There is a need to identify, screen and critical follow high-risk mothers and give immediate and appropriate intervention as early as possible.

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Identification of Environmental Factors Associated with Inflammatory Bowel Disease in a Southwestern Highland Region of China: A Nested Case-Control Study

PLoS ONE ◽

10.1371/journal.pone.0153524 ◽

2016 ◽

Vol 11 (4) ◽

pp. e0153524 ◽

Cited By ~ 19

Author(s):

Junkun Niu ◽

Jiarong Miao ◽

Yuan Tang ◽

Qiong Nan ◽

Yan Liu ◽

...

Keyword(s):

Inflammatory Bowel Disease ◽

Environmental Factors ◽

Bowel Disease ◽

Case Control Study ◽

Case Control ◽

Factors Associated ◽

Highland Region ◽

Inflammatory Bowel ◽

Nested Case Control ◽

Control Study

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Risk factors for progression of juvenile-onset non-radiographic axial spondyloarthritis to juvenile-onset ankylosing spondylitis: a nested case–control study

RMD Open ◽

10.1136/rmdopen-2021-001867 ◽

2021 ◽

Vol 7 (3) ◽

pp. e001867

Author(s):

Hao-Guang Li ◽

Dan-Min Wang ◽

Feng-Cai Shen ◽

Shu-Xin Huang ◽

Zhi-Duo Hou ◽

...

Keyword(s):

Risk Factors ◽

Case Control Study ◽

Axial Spondyloarthritis ◽

Disease Onset ◽

Case Control ◽

Buttock Pain ◽

Juvenile Onset ◽

Factors Associated ◽

Nested Case Control ◽

Control Study

ObjectiveTo evaluate the clinical characteristics of juvenile-onset non-radiographic axial spondyloarthritis (nr-axSpA) and to investigate risk factors associated with progression to juvenile-onset ankylosing spondylitis (JoAS).MethodsA nested case–control study was conducted using the retrospectively collected data of 106 patients with juvenile-onset nr-axSpA (age at disease onset, <16 years) in the Clinical characteristic and Outcome in Chinese Axial Spondyloarthritis study cohort. Baseline demographic and clinical characteristics and prognosis were reviewed. Logistic regression analyses were performed to investigate risk factors associated with progression to JoAS.ResultsOverall, 58.5% of patients with juvenile-onset nr-axSpA presented with peripheral symptoms at disease onset. In 82.1% of these patients, axial with peripheral involvement occurred during the disease course. The rate of disease onset at >12 years and disease duration of ≤10 years were significantly higher in those with progression to JoAS than in those without progression to JoAS (83.0% vs 52.8%, p=0.001; 92.5% vs 56.6%, p<0.001, respectively). Multivariable logistic regression analysis revealed that inflammatory back pain (IBP) (OR 13.359 (95% CI 2.549 to 70.013)), buttock pain (OR 10.171 (95% CI 2.197 to 47.085)), enthesitis (OR 7.113 (95% CI 1.670 to 30.305)), elevated baseline C reactive protein (CRP) levels (OR 7.295 (95% CI 1.984 to 26.820)) and sacroiliac joint-MRI (SIJ-MRI) positivity (OR 53.821 (95% CI 9.705 to 298.475)) were significantly associated with progression to JoAS.ConclusionPeripheral involvement was prevalent in juvenile-onset nr-axSpA. IBP, buttock pain, enthesitis, elevated baseline CRP levels and SIJ-MRI positivity in patients with the disease are associated with higher risk of progression to JoAS.

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Factors associated with induced abortion among women of reproductive age attending selected health facilities in Addis Ababa, Ethiopia: a case control study

BMC Women s Health ◽

10.1186/s12905-020-01023-4 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Bikila Soboka Megersa ◽

Oladosu Akanbi Ojengbede ◽

Andreas Deckert ◽

Olufunmilayo Ibitola Fawole

Keyword(s):

Case Control Study ◽

Addis Ababa ◽

Case Control ◽

Induced Abortion ◽

Health Facilities ◽

Reproductive Age ◽

Women Of Reproductive Age ◽

Factors Associated ◽

Control Study

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Barriers to Adherence to Antimicrobial Stewardship Postprescription Review and Feedback For Broad-Spectrum Antimicrobial Agents: A Nested Case-Control Study

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa298 ◽

2020 ◽

Vol 7 (8) ◽

Author(s):

Akane Takamatsu ◽

Kenta Yao ◽

Shutaro Murakami ◽

Yasuaki Tagashira ◽

Shinya Hasegawa ◽

...

Keyword(s):

Antimicrobial Stewardship ◽

Broad Spectrum ◽

Case Control Study ◽

Tertiary Care ◽

Previous History ◽

Multivariate Logistic Regression Analysis ◽

Case Control ◽

Factors Associated ◽

Nested Case Control ◽

Control Study

Abstract Background Postprescription review and feedback (PPRF) is one of the most common strategies in antimicrobial stewardship program (ASP) intervention. However, disagreements between the prescribers and ASP personnel can occur. The aim of the present study was to identify the factors associated with nonadherence to PPRF intervention. Methods The present retrospective nested case-control study was performed at a tertiary care center, which has been conducting a once-weekly PPRF for carbapenems and piperacillin/tazobactam since 2014. Nonadherence to ASP recommendations was defined as the failure of the primary care team to modify or stop antimicrobial therapy 72 hours after the issuance of PPRF recommendations. Factors associated with nonadherence to PPRF intervention were identified using multivariate logistic regression analysis. Results In total, 2466 instances of PPRF in 1714 cases between April 2014 and September 2019 were found. The nonadherence rate was 5.9%, and 44 cases were found in which carbapenems or piperacillin/tazobactam continued to be used against PPRF recommendations. Factors associated with nonadherence to PPRF recommendations were a previous history of hospitalization within 90 days (adjusted odds ratio [aOR], 2.62; 95% confidence interval [CI], 1.18–5.81) and a rapidly fatal McCabe score at the time of PPRF intervention (aOR, 2.87; 95% CI, 1.18–6.98). A review of the narrative comments in the electronic medical records indicated that common reasons for nonadherence were “the patient was sick” (n = 12; 27.3%) and “the antimicrobial seemed to be clinically effective” (n = 9; 20.5%). Conclusions Nonadherence to PPRF recommendations was relatively uncommon at the study institution. However, patients with a severe disease condition frequently continued to receive broad-spectrum antimicrobials against PPRF recommendations. Understanding physicians’ cognitive process in nonadherence to ASP recommendations and ASP interventions targeting medical subspecialties caring for severely ill patients is needed to improve ASP.

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Determinants of maternal near miss events: a facility based case-control study

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20193497 ◽

2019 ◽

Vol 6 (8) ◽

pp. 3614

Author(s):

Mahesh D. Kurugodiyavar ◽

Kashavva B. Andanigoudar ◽

Dattatreya D. Bant ◽

Manjunath S. Nekar

Keyword(s):

Case Control Study ◽

Care Delivery ◽

Healthcare Services ◽

Case Control ◽

Near Miss ◽

Maternal Near Miss ◽

Maternal Deaths ◽

Danger Signs ◽

Postnatal Women ◽

Control Study

Background: Worldwide, approximately 830 women died every single day due to complications during pregnancy or childbirth in 2015. Many researchers revealed that the quality of health care delivery in a system can be identified by studies on maternal deaths. In recent years, women who survived the critical events during pregnancy and childbirth, called as maternal near miss cases, are explored as an adjunct to maternal death inquiries, as these cases occur more frequently than maternal deaths and can identify problems that had to be overcome for the provision of better healthcare services. This study aims at evaluating determinants of such maternal near miss events among postnatal women admitted in KIMS Hospital, Hubli.Methods: A case-control study was done on postnatal women admitted in the KIMS Hospital. A structured pre-tested questionnaire was administered to 82 participants (27 cases and 55 controls). Information about biodata, sociodemographic characteristics, medical illnesses, previous pregnancies and the current pregnancy with its outcomes and complications was collected.Results: Most women were satisfying the criterion for admission to ICU followed by hypertensive complications and severe anemia, to be considered as cases. The study showed height, type of family, religion, presence of danger signs during pregnancy as significant determinants of maternal near miss events.Conclusions: The factors showing significance in our study are non-modifiable risk factors of maternal near miss events. With early identification of such cases and appropriate antenatal care, such events can be prevented and reduced.

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Epilepsy and mortality: a retrospective cohort analysis with a nested case–control study identifying causes and risk factors from primary care and linkage-derived data

BMJ Open ◽

10.1136/bmjopen-2021-052841 ◽

2021 ◽

Vol 11 (10) ◽

pp. e052841

Author(s):

Gabriella Wojewodka ◽

Martin C Gulliford ◽

Mark Ashworth ◽

Mark P Richardson ◽

Leone Ridsdale

Keyword(s):

Risk Factors ◽

Primary Care ◽

General Population ◽

Cause Of Death ◽

Retrospective Cohort ◽

Case Control Study ◽

Case Control ◽

Factors Associated ◽

Nested Case Control ◽

Control Study

ObjectivesPeople with epilepsy (PWE) have a higher mortality rate than the general population. Epilepsy-related deaths have increased despite all-cause mortality decreasing in the general population pre-COVID-19. We hypothesised that clinical and lifestyle factors may identify people more at risk.DesignWe used a retrospective cohort study to explore cause of death and a nested case–control study to identify risk factors.SettingWe explored factors associated with mortality using primary care population data from 1 April 2004 to 31 March 2014. Data were obtained from the Clinical Practice Research Datalink which compiles anonymised patient data from primary care in the UK. Cause of death data was supplemented from the Office of National Statistics when available.ParticipantsThe analysis included 70 431 PWE, with 11 241 registered deaths.ResultsThe number of deaths within the database increased by 69% between the first and last year of the study. Epilepsy was considered as a contributing cause in approximately 45% of deaths of PWE under 35. Factors associated with increased risk of death included attendance at emergency departments and/or emergency admissions (OR 3.48, 95% CI 3.19 to 3.80), antiepileptic drug (AED) polytherapy (2 AEDs: OR 1.60, 95% CI 1.51 to 1.71; 3 AEDs: OR 2.06, 95% CI 1.86 to 2.29; 4+AEDs: OR 2.62, 95% CI 2.23 to 3.08), status epilepticus (OR 2.78, 95% CI 1.64 to 4.71), depression (OR 1.67, 95% CI 1.57 to 1.76) and injuries (OR 1.54, 95% CI 1.43 to 1.67). No seizures in the prior year (OR 0.52, 95% CI 0.41 to 0.65).ConclusionOur results add to existing evidence that deaths in epilepsy are increasing. Future studies could focus on identifying PWE at high risk and addressing them with clinical interventions or better self-management. Identifying specific risk factors for younger people should be a priority as epilepsy may be a factor in close to half of deaths of PWE under 35 years of age.

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