Magnitude of maternal near misses and the role of delays in Ethiopia: a hospital based cross-sectional study

Worke, Mulugeta Dile; Enyew, Habtamu Demelash; Mekie, Maru

doi:10.1186/s13104-019-4628-y

Cited by 23 publications

(20 citation statements)

References 23 publications

(28 reference statements)

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“…If a mother lacks ANC, minor obstetric conditions are not detected and managed early, serious complications and MNM will likely develop. This finding is contradictory to studies carried out in Bolivia [44] and northern Ethiopia [45], which indicated that routine ANC has an indirect impact on a maternal near-miss, likely by preventing the delay in seeking treatment through raising awareness of timely care. Therefore, the concerted effort needed by health care providers to track those mothers without antenatal care is key in reducing the incidence of MNM.…”

Section: Discussioncontrasting

confidence: 95%

Determinants of maternal near miss among women admitted to maternity wards of tertiary hospitals in Southern Ethiopia, 2020: A hospital-based case-control study

Habte¹,

Wondimu

2021

PLoS ONE

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Background A maternal near-miss (MNM) refers to when a gravely ill woman survives a complication as a result of the standard of care she receives or by chance during gestation, childbirth, or within 42 days of the termination of pregnancy. Rescuers of near-miss events share several features with mothers who have died and identifying MNM determinants will aid in improving the capacity of the health system to reduce severe maternal morbidity and mortality. Ethiopia is one of the countries in sub-Saharan Africa with high maternal mortality and morbidity, but there is little evidence on determinants of a MNM based on a WHO criteria. Hence, this study aimed at identifying determinants of MNM among women admitted to tertiary hospitals in southern Ethiopia, 2020. Methods A facilities-based unmatched case-control study was conducted in five selected tertiary hospitals found in central southern Ethiopia from February 1 to June 1, 2020. A total of 322 (81 cases and 241 controls) study participants were included in the study. At the time of their discharge, cases were recruited consecutively, while controls were selected using a systematic sampling method. The cases were women admitted to hospitals during pregnancy, childbirth, or 42 days following termination of pregnancy who met at least one of the WHO near-miss criteria. Whereas the controls comprised of women who were admitted during pregnancy, childbirth, or 42 days following termination of pregnancy and discharged without severe obstetric complications. Data collection was conducted using the interviewer-administered structured questionnaire and data abstraction tool. The data was coded and entered into Epi-Data version 3.1 and exported to SPSS version 23 for analysis. Multivariable logistic regression analysis was conducted and determinants of MNM were established at p-value<0.05. Results Severe postpartum hemorrhage (50.6%) and sepsis (23.4%) were the most common reasons for admission of cases. Lack of ANC [AOR = 3.25; 95%CI: 2.21,7.69], prior history of Cesarean section [AOR = 3.53; 95%CI:1.79,6.98], delaying more than 60 minute to access final place of care [AOR = 3.21; 95%CI:1.61,6.39], poor practice of Birth preparedness and complication readiness (BPCR) [AOR = 3.31; 95%CI:1.50,7.29], and history of preexisting medical disorders [AOR = 2.79; 95%CI:1.45,5.37] were identified as significantly determinants of maternal near miss. Conclusion and recommendation Stakeholders need to enhance their efforts for improving access to roads and transportations. Besides, women who have a prior history of Caesarean section, chronic medical conditions, and no ANC need special attention from their families and health care providers to proactively mitigate the occurrence of serious obstetric complications. More attention has to be paid to birth preparedness and complication readiness activities.

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Section: Discussioncontrasting

confidence: 95%

Determinants of maternal near miss among women admitted to maternity wards of tertiary hospitals in Southern Ethiopia, 2020: A hospital-based case-control study

Habte¹,

Wondimu

2021

PLoS ONE

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“…Second, maternal delay (time to reach the final care health facility) was found to have a significantly associated factor with a maternal near miss. This finding is in line with the study done in south Ethiopia, the Amhara region, the Tigray region, and Jimma [26,27,31,32] respectively.…”

Section: Discussionsupporting

confidence: 92%

Prevalence and Associated Factors with Maternal Near-Miss among Pregnant Women at Hawassa University Comprehensive Specialized Hospital, Sidama Region, Ethiopia

Tolesa¹,

Abera²,

Worku³

et al. 2021

Int J Womens Health Wellness

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“…Women with no ANC were also more likely to develop MNM compared to women who had at least one. Similar association of no ANC and MNM has been previously reported in Ethiopia [ 36 , 37 ], Brazil [ 38 ], and Nigeria [ 39 ]. This indicates the importance of ANC in identifying pregnancy complications and providing early treatment which gives the opportunity for early detections and treatments of complications thereby reducing near miss events.…”

Section: Discussionsupporting

confidence: 87%

Maternal near miss among women admitted in major private hospitals in eastern Ethiopia: a retrospective study

Tenaw

Assefa

Mulatu

et al. 2021

BMC Pregnancy Childbirth

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Background Since maternal mortality is a rare event, maternal near miss has been used as a proxy indicator for measuring maternal health. Maternal near miss (MNM) refers to a woman who nearly died but survived of complications during pregnancy, childbirth or within 42 days of termination of pregnancy. Although study of MNM in Ethiopia is becoming common, it is limited to public facilities leaving private facilities aside. The objective of this study was to assess MNM among women admitted in major private hospitals in eastern Ethiopia. Methods An institution based retrospective study was conducted from March 05 to 31, 2020 in two major private hospitals in Harar and Dire Dawa, eastern Ethiopia. The records of all women who were admitted during pregnancy, delivery or within 42 days of termination of pregnancy was reviewed for the presence of MNM criteria as per the sub-Saharan African MNM criteria. Descriptive analysis was done by computing proportion, ratio and means. Factors associated with MNM were assessed using binary logistic regression with adjusted odds ratio (aOR) along with its 95% confidence interval (CI). Results Of 1214 pregnant or postpartum women receiving care between January 09, 2019 and February 08, 2020, 111 women developed life-threatening conditions: 108 MNM and 3 maternal deaths. In the same period, 1173 live births were registered, resulting in an MNM ratio of 92.1 per 1000 live births. Anemia in the index pregnancy (aOR: 5.03; 95%CI: 3.12–8.13), having chronic hypertension (aOR: 3.13; 95% CI: 1.57–6.26), no antenatal care (aOR: 3.04; 95% CI: 1.58–5.83), being > 35 years old (aOR: 2.29; 95%CI: 1.22–4.29), and previous cesarean section (aOR: 4.48; 95% CI: 2.67–7.53) were significantly associated with MNM. Conclusions Close to a tenth of women admitted to major private hospitals in eastern Ethiopia developed MNM. Women with anemia, history of cesarean section, and old age should be prioritized for preventing and managing MNM. Strengthening antenatal care and early screening of chronic conditions including hypertension is essential for preventing MNM.

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Magnitude of maternal near misses and the role of delays in Ethiopia: a hospital based cross-sectional study

Cited by 23 publications

References 23 publications

Determinants of maternal near miss among women admitted to maternity wards of tertiary hospitals in Southern Ethiopia, 2020: A hospital-based case-control study

Determinants of maternal near miss among women admitted to maternity wards of tertiary hospitals in Southern Ethiopia, 2020: A hospital-based case-control study

Prevalence and Associated Factors with Maternal Near-Miss among Pregnant Women at Hawassa University Comprehensive Specialized Hospital, Sidama Region, Ethiopia

Maternal near miss among women admitted in major private hospitals in eastern Ethiopia: a retrospective study

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