<p>Incidence-Proportion of Maternal Near-Misses and Associated Factors in Southwest Ethiopia: A Prospective Cross-Sectional Study</p>

Abstract

Background: Pregnancy-related morbidity and mortality continue to have a serious impact on the lives of women all over the world. Women in sub-Saharan Africa accounted for nearly two-thirds of global maternal deaths. The World Health Organization recommends monitoring maternal near-miss provides better information regarding the quality of maternal health care, on which to base action to prevent further death. Accordingly, this study sought to assess the incidence-proportion of maternal near-miss and its risk factors. We have also seen the near-miss-to-mortality ratio and overall maternal mortality index. Methods: An institution-based prospective cross-sectional study was carried out from February 6, 2017 to March 6, 2017, using the WHO criteria for maternal near-misses at the three randomly selected public hospitals. About 845 participants were enrolled in the study with systematic random sampling techniques. WHO multi-country survey on maternal and neonatal health tool was used. Descriptive statistics and bivariate logistic regression analysis were done. Variables with p-value <0.2 in the bivariate analysis were transferred to multivariable analysis, and during multivariate logistic regression analysis, variables with P-value <0.05 were considered as statistically significant with 95% CI. Results: There were 5530 live births, 210 maternal near-misses, 17 maternal deaths, and 364 maternal near-miss events. The overall proportion of maternal near-miss is 24.85%. Besides, the ratio of maternal near-misses to maternal mortality was 12.35:1, and the overall mortality index was 7.48%. Parity, residence, a distance of maternal home from the hospital, ANC follow-up, duration of labor, and administration-related problems were found to have statistically significant associations. Conclusion: The incidence-proportion of maternal near-misses is relatively high when compared against the national target and to other regional studies. Besides, with all its limitations, the outcome indicators and outcome measures in this study seem to suggest optimum care is being given to mothers who suffered from life-threatening complications.

Clinical and Sociodemographic Characteristics Associated with Emergency Peripartum Hysterectomy due to Puerperal Sepsis in Malawi

“…14 A study in Southwest Ethiopia found that the odds of maternal nearmisses among multiparous women were 2.5 times that of nulliparous women. 15 Cesarean mode of delivery was significantly associated with a risk of undergoing an emergency peripartum hysterectomy in our sample of women in Malawi. Seventy-six percent of our cohort delivered via cesarean.…”

“… 14 A study in Southwest Ethiopia found that the odds of maternal near-misses among multiparous women were 2.5 times that of nulliparous women. 15 …”

Fatores de risco para near miss materno: revisão integrativa [Risk factors for maternal near miss: an integrative review] [Factores de riesgo para near miss materno: revisión integrativa]

“…Rev enferm UERJ, Rio de Janeiro, 2022; 30:e65125 p.5 Nos 12 estudos que compuseram a revisão, foram identificados fatores sociodemográficos associados à ocorrência de NMM, envolvendo possuir menor grau de escolaridade 2,5,12-15 , residir no interior ou em área rural 2,14,20 , ter baixa renda 2,12-14,21 e ser extremos de idade 5,12,15,21 ; e obstétricos, com destaque para cesariana prévia 9,18,19 ou na gestação analisada 2,5,16,18,21 , aborto anterior 13,21 , primiparidade 15,19 e falhas na atenção pré-natal 2,13,18,19,21 .…”

“…Como fatores clínicos e obstétricos relacionados à ocorrência de NMM, destacam-se as seguintes complicações obstétricas: os distúrbios hipertensivos, que apareceram em 10 dos 12 estudos desta revisão 2,5,12,13,[15][16][17][18][19]21 ; as complicações hemorrágicas, em nove estudos 2,5,12,13,15-20 ; a sepse, mencionada em cinco estudos 2,12,[17][18][19] ; e o histórico gestacional de anemia, relatado em quatro artigos 12,14,18,20 . Nos fatores clínicos maternos preexistentes, foram evidenciadas doenças crônicas, como a hipertensão 14,18 .…”

“…Além destes, a demora no tempo de deslocamento para atendimento 12,13,[18][19][20] , o encaminhamento de outro serviço 17,20 e o baixo peso ao nascer 17,18,21 também transparecem como fatores que se relacionam aos casos de NMM.…”