Incidence and main causes of severe maternal morbidity in São Luís, Maranhão, Brazil: a longitudinal study

Moraes, A. P.; Barreto, Sandhi Maria; Passos, Valéria Maria Azeredo; Golino, Patrícia Silva; Costa, Janne Ayre; Vasconcelos, M.

doi:10.1590/s1516-31802011000300005

Cited by 20 publications

(21 citation statements)

References 28 publications

(65 reference statements)

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“…In addition, the association between high MNM prevalence and hemorrhagic complications has implications for maternal‐mortality risk in Uganda. Moraes et al [12] found that women who experienced hemorrhagic complications were at an increased risk of maternal death than those who experienced other complications. Similarly, hemorrhagic complications have previously been reported to be the main cause of severe maternal morbidity and mortality in Uganda [7,13].…”

Section: Discussionmentioning

confidence: 99%

Prevalence of maternal near miss and community-based risk factors in Central Uganda

Nansubuga

Ayiga

Moyer

2016

International Journal of Gynecology & Obstetrics

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MNM morbidity is a significant burden in Central Uganda. The present study demonstrated higher MNM rates compared with studies employing organ-failure MNM-diagnostic criteria. These findings illustrate the need to look beyond mortality statistics when assessing maternal health outcomes. Concerted efforts to increase supervised deliveries, access to emergency obstetric care, and access to contraceptives are warranted.

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Section: Discussionmentioning

confidence: 99%

Prevalence of maternal near miss and community-based risk factors in Central Uganda

Nansubuga

Ayiga

Moyer

2016

International Journal of Gynecology & Obstetrics

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“…The present study used the criteria proposed by the World Health Organization in 2009 [30], whereas other studies have used different defining criteria such as those established by Mantel or Waterstone [22,26,27]. …”

Section: Discussionmentioning

confidence: 99%

Factors associated with severe maternal morbidity and near miss in the São FranciscoValley, Brazil: a retrospective, cohort study

Pacheco

Katz

Souza

et al. 2014

BMC Pregnancy Childbirth

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BackgroundMaternal mortality remains a major public health issue worldwide, with persistent high rates prevailing principally in underdeveloped countries. The objective of this study was to determine the risk factors for severe maternal morbidity and near miss (SMM/NM) in pregnant and postpartum women at the maternity ward of the Dom Malan Hospital, Petrolina, in northeastern Brazil.MethodsA retrospective, cohort study was conducted to evaluate the sociodemographic and obstetric characteristics of the women. Patients who remained hospitalized at the end of the study period were excluded. Risk ratios (RR) and their respective 95% confidence intervals (95% CI) were calculated as a measure of relative risk. Hierarchical multiple logistic regression was also performed. Two-tailed p-values were used for all the tests and the significance level adopted was 5%.ResultsA total of 2,291 pregnant or postpartum women receiving care between May and August, 2011 were included. The frequencies of severe maternal morbidity and near miss were 17.5% and 1.0%, respectively. Following multivariate analysis, the factors that remained significantly associated with an increased risk of SMM/NM were a Cesarean section in the current pregnancy (OR: 2.6; 95% CI: 2.0 – 3.3), clinical comorbidities (OR: 3.4; 95% CI: 2.5 – 4.4), having attended fewer than six prenatal visits (OR: 1.1; 95% CI: 1.01 – 1.69) and the presence of the third delay (i.e. delay in receiving care at the health facility) (OR: 13.3; 95% CI: 6.7 – 26.4).ConclusionsThe risk of SMM/NM was greater in women who had been submitted to a Cesarean section in the current pregnancy, in the presence of clinical comorbidities, fewer prenatal visits and when the third delay was present. All these factors could be minimized by initiating a broad debate on healthcare policies, introducing preventive measures and improving the training of the professionals and services providing obstetric care.

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“…In Sao Luis, the State Capital with the lowest income per capita in the country [11], maternal mortality is even higher than the estimated for the country (84.6/100,000 live births in 2006) [12]. We conducted a previous cohort study which showed that obstetric reasons were the main causes of severe maternal morbidity in the city [13]. The objective of the present study is to identify the risk factors for severe maternal morbidity in the same population.…”

Section: Introductionmentioning

confidence: 99%

Severe maternal morbidity: a case-control study in Maranhao, Brazil

et al. 2013

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BackgroundMaternal mortality and morbidity are among the top public health priorities in Brazil, being quite high, especially among the most disadvantage women. A case control study was developed to identify risk factors for severe maternal morbidity in Sao Luis, one of the poorest Brazilian State Capitals.MethodsThe case–control study was carried out between 01/03/2009 and 28/02/2010 in two public high-risk maternities facilities and in two intensive care units (ICUs) for referral of obstetric cases. All cases hospitalized due to complications during gestation period, childbirth or up to 42 days of puerperium and who fulfilled any of Mantel's and/or Waterstone's criteria were identified. Two controls per case were randomly selected among patients of the same clinics discharged for other reasons. Data were obtained through a structured interview as well as from medical charts and prenatal cards and included sociodemographic variables, clinical and obstetric histories, behavioral factors and exposure to stress factors during pregnancy, pre-natal assistance and obstetric complication and childbirth care.ResultsIn the final model of the unconditional logistic regression analysis, being older than 35 years (OR=3.11; 95% CI:1.53-6.31), previous hypertension (OR=2.52; 95% CI:1.09-5.80), history of abortion (OR=1.61; 95% CI:0.97-2.68), 4–5 pre-natal consultations (OR=1.78; 95% CI:1.05-3.01) and 1–3 pre-natal consultations (OR=1.89; 95% CI:1.03-3.49) were independently associated with severe maternal morbidity.ConclusionsThe results corroborate the importance of reproductive healthcare, of identifying a high-risk pregnancy and of a qualified and complete prenatal care to prevent severe morbid events.ResumoIntroduçãoA mortalidade e morbidade maternas estão entre os tópicos prioritários da Saúde Pública brasileira, especialmente na população de menor nível socioeconômico. Um estudo caso-controle foi desenvolvido para identificar os fatores de risco para morbidade materna grave em São Luís, capital de um dos estados mais pobres do Brasil.MétodoEstudo caso-controle realizado em duas maternidades públicas de alto risco e duas UTIs de referência aos casos obstétricos entre 01/03/2009 e 28/02/2010. Foram incluídas todas as pacientes internadas por complicação do período grávido-puerperal e que preenchiam os critérios de Waterstone e/ou Mantel para morbidade materna grave. Foram selecionados para cada caso, dois controles por sorteio aleatório dentre as pacientes internadas no mesmo período e mesma maternidade que o caso. As informações de domínio sociodemográfico, clínico, obstétrico, comportamental, exposição a eventos estressores na gestação, assistência ao pré-natal, intercorrências obstétricas e atenção ao parto, foram obtidas por meio de entrevista estruturada. As variáveis foram analisadas por modelo de regressão logística múltipla não condicional, baseado em modelo hierarquizado a priori.ResultadosForam identificados como fatores de risco para morbidade materna grave: idade >35 anos (OR=3,11; IC 95%:1,53-6,31), hipertens...

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Incidence and main causes of severe maternal morbidity in São Luís, Maranhão, Brazil: a longitudinal study

Cited by 20 publications

References 28 publications

Prevalence of maternal near miss and community-based risk factors in Central Uganda

Prevalence of maternal near miss and community-based risk factors in Central Uganda

Factors associated with severe maternal morbidity and near miss in the São FranciscoValley, Brazil: a retrospective, cohort study

Severe maternal morbidity: a case-control study in Maranhao, Brazil

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