General and reproductive health among women after an episode of severe maternal morbidity: Results from the COMMAG study

• Published in: International journal of gynecology and obstetrics Vol. 150; no. 1; pp. 83 - 91
• Main Authors: Ferreira, Elton C., Costa, Maria L., Pacagnella, Rodolfo C., Silveira, Carla, Andreucci, Carla B., Zanardi, Dulce M., Santos, Juliana P., Angelini, Carina R., Souza, Renato T., Parpinelli, Mary A., Sousa, Maria H., Cecatti, Jose G.
• Format: Journal Article
• Language: English
• Published: United States 01-07-2020
• Subjects: General health; Maternal death; Maternal near miss; Postpartum period; Pregnancy; Reproductive health; Severe maternal morbidity; Pregnancy; Reproductive health; Postpartum period; General health; Maternal near miss; Severe maternal morbidity; Maternal death
• ISSN: 0020-7292; 1879-3479
• DOI: 10.1002/ijgo.13161

Objective
To assess general and reproductive health in women after severe maternal morbidity (SMM).
Methods
A retrospective cohort study was performed at a tertiary maternity hospital. Women with SMM criteria who delivered during 2008–2012 were included in the SMM group. The control group included a random sample of women without SMM delivering in the same year of cases. Both groups were compared regarding sociodemographic/obstetric characteristics, general and reproductive health, using χ2, Yates χ2, Fisher exact, and Mann‐Whitney tests.
Results
There were 315 women in the SMM group and 323 women in the control group. The SMM group was older and had a history of more medical conditions (hypertension, diabetes, obesity), cesarean deliveries, preterm births, and perinatal deaths. Breastfeeding was negatively affected in these women, as was fertility. The SMM group had a non‐significant trend of fewer children after index pregnancy, had new complications in subsequent pregnancies, and required specialized medical care, besides higher risk of death.
Conclusion
Women experiencing SMM are at higher risk of general and reproductive health problems after pregnancy, including risk of death. Therefore, their surveillance and follow‐up should continue beyond 42 days postpartum, highlighting the importance of more specialized health care.
Women experiencing severe maternal morbidity are at higher risk of developing general and reproductive health problems after pregnancy.