Factors associated with maternal mortality among patients meeting criteria of severe maternal morbidity and near miss

Objective To evaluate factors associated with maternal death among women experiencing life‐threatening conditions during pregnancy, childbirth, or within 42 days of termination of pregnancy. Methods A secondary analysis of data prospectively collected in a Brazilian multicenter cross‐sectional study...

Full description

Saved in:

Bibliographic Details
Published in:	International journal of gynecology and obstetrics Vol. 136; no. 3; pp. 337 - 343
Main Authors:	Lima, Hesly M.P., Carvalho, Francisco Herlânio C., Feitosa, Francisco Edson L., Nunes, George C.
Format:	Journal Article
Language:	English
Published:	United States 01-03-2017
Subjects:	Adolescent Adult Brazil Cause of Death Child Cross-Sectional Studies Female Humans Infant, Newborn Intensive Care Units Logistic Models Male Maternal Health - standards Maternal morbidity Maternal Mortality Middle Aged Morbidity Near miss approach to maternal health Near Miss, Healthcare - statistics & numerical data Obstetric Labor Complications - etiology Obstetric Labor Complications - mortality Perinatal Mortality Pregnancy Pregnancy Complications - mortality Risk Factors Socioeconomic Factors WHO World Health Organization Young Adult Maternal morbidity Maternal mortality Near miss approach to maternal health Cause of death Morbidity WHO
Online Access:	Get full text
Tags:	Add Tag No Tags, Be the first to tag this record!

Description
Summary:	Objective To evaluate factors associated with maternal death among women experiencing life‐threatening conditions during pregnancy, childbirth, or within 42 days of termination of pregnancy. Methods A secondary analysis of data prospectively collected in a Brazilian multicenter cross‐sectional study between July 2009 and June 2010 was conducted. Women were identified who delivered at a hospital in Ceará and who had potentially life‐threatening conditions. Stepwise logistic regression was used to identify factors associated with maternal death. Results Overall, 941 women were identified and 11 died. Among criteria for severe maternal morbidity, eclampsia (adjusted odds ratio [aOR] 203.70, 95% CI 5.03 to 8254.20; P=0.005) and intensive care unit (ICU) admission (aOR 69.30, 95% CI 6.63–724.26; P<0.001) were risk factors for progression to death, whereas use of magnesium sulfate (aOR 0.002, 95% CI <0.01–0.11; P=0.002) was a protective factor. Meeting near‐miss criteria other than survival (aOR 5.96, 95% CI 1.69–20.98; P=0.005) was associated with maternal death. Of criteria for near miss, management criteria were most strongly associated with maternal death: all 11 women who died met some management criteria. Conclusion Among WHO's criteria for severe maternal morbidity and near miss, eclampsia, low oxygen saturation, ICU admission, intubation, mechanical ventilation, and cardiopulmonary resuscitation were most associated with maternal death. Use of magnesium sulfate was a protective factor. The WHO criteria for severe maternal morbidity and near miss were found to be risk factors for maternal death.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0020-7292 1879-3479
DOI:	10.1002/ijgo.12077