Maternal Near Miss and Still birth in developing countries: A Systematic Review with Meta-Analysis

Firdawek, Ewnetu; Worku, Alemayehu

doi:10.4172/2376-127x.1000209

Cited by 4 publications

(3 citation statements)

References 18 publications

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“…Besides, we depicted that women who had pregnant-related complications during pregnancy, childbirth, and immediately after childbirth were more likely to have adverse birth outcomes. This finding is consistent with evidence from low and middle-income countries [ 45 ], Developing countries [ 46 ], Ghana [ 26 ], the Indian State of Bihar [ 34 ], Jimma Zone [ 21 ], and Gondar University Hospital [ 29 ]. This is the fact that women who have pregnant-related complications were prone to infection and birth asphyxia which are the leading cause of stillbirth, neonatal death, and neonatal illness.…”

Section: Discussionsupporting

confidence: 90%

The effects of completion of continuum of care in maternal health services on adverse birth outcomes in Northwestern Ethiopia: a prospective follow-up study

2022

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Background Globally, around 4 million babies die within the first month of birth annually with more than 3 million stillbirths. Of them, 99% of newborn deaths and 98% of stillbirths occur in developing countries. Despite giving priority to maternal health services, adverse birth outcomes are still major public health problems in the study area. Hence, a continuum of care (CoC) is a core key strategy to overcome those challenges. The study conducted on the effectiveness of continuum of care in maternal health services was scarce in developing countries and not done in the study area. We aimed to assess the effectiveness of continuum of care and determinants of adverse birth outcomes. Methods Community and health facility-linked prospective follow-up study designs were employed from March 2020 to January 2021 in Northwestern Ethiopia. A multistage clustered sampling technique was used to recruit 2198 pregnant women. Data were collected by using a semi-structured and pretested questionnaire. Collected data were coded, entered, cleaned, and analyzed by STATA 14. Multilevel logistic regression model was used to identify community and individual-level factors. Finally, propensity score matching was applied to determine the effectiveness of continuum of care. Results The magnitude of adverse birth outcomes was 12.4% (95% CI 12.2–12.7): stillbirth (2.8%; 95% CI 2.7–3.0), neonatal mortality (3.1%; 95% CI 2.9–3.2), and neonatal morbidity (6.8%; 95% CI 6.6–7.0). Risk factors were poor household wealth (AOR = 3.3; 95% CI 1.07–10.23), pregnant-related maternal complications during pregnancy (AOR = 3.29; 95% CI 1.68–6.46), childbirth (AOR = 6.08; 95% CI 2.36–15.48), after childbirth (AOR = 5.24; 95% CI 2.23–12.33), an offensive odor of amniotic fluid (AOR = 3.04; 95% CI 1.37–6.75) and history of stillbirth (AOR = 4.2; 95% CI 1.78–9.93). Whereas, receiving iron-folic acid (AOR = 0.44; 95% CI 0.14–0.98), initiating breastfeeding within 1 h (AOR = 0.22; 95% CI 0.10–0.50) and immunizing newborn (AOR = 0.33; 95% CI 0.12–0.93) were protective factors. As treatment effect, completion of continuum of care via time dimension (β = − 0.03; 95% CI − 0.05, − 0.01) and space dimension (β = − 0.03; 95% CI − 0.04, − 0.01) were significantly reduce perinatal death. Conclusions Adverse birth outcomes were high as compared with national targets. Completion of continuum of care is an effective intervention for reducing perinatal death. Efforts should be made to strengthen the continuum of care in maternal health services, iron supplementation, immunizing and early initiation of breastfeeding.

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Section: Discussionsupporting

confidence: 90%

The effects of completion of continuum of care in maternal health services on adverse birth outcomes in Northwestern Ethiopia: a prospective follow-up study

2022

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“…Beside, we depicted that women who had pregnant-related complications during pregnancy, labour and childbirth and immediately after childbirth were more likely to have adverse birth outcomes. This nding consistent with evidence from low-and middle-income countries (43), Developing countries (44), Ghana (23), Indian State of Bihar(31), Jimma Zone(18) and Gondar University Hospital(26). This is the fact that women who have pregnant related complications were prone for infection and birth asphyxia which are the leading cause of stillbirth, neonatal death and neonatal illness.…”

Section: Status Of Adverse Birth Outcomesupporting

confidence: 89%

Effects of continuum of care in maternal health services on adverse birth outcome in Northwest Ethiopia: a prospective follow up study

Zelka¹,

Yalew²,

Debelew³

2021

Preprint

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Background Globally, around 4 million of babies were died within the first month and more than 3 million were stillbirth. Of them, 99% of newborn deaths and 98% of stillbirth occur in developing countries. Despite give a priority for maternal health services, adverse birth outcomes are still major public health problems and big challenge in Ethiopia particularly in study area. Hence, to overcome those challenges, a continuum of care (COC) is core key strategies. Despite that study conduct on effectiveness of COC in maternal health services was scare in developing countries and not done in study area. We aimed to assess effectiveness of continuity of care on reduction of adverse events and determinants of adverse birth outcomes. Methods Community and health facility linked prospective follow-up study design was employed from March 2020 to January 2021 in Northwest Ethiopia. A multistage sampling technique was used to recruit 2,198 pregnant women. Data were collected by using semi-structured and pretested interviewer questionnaire. Collected data were coded, entered, cleaned and analyzed by using STATA 14. Mixed-effect model was used to identify community and individual level factors of adverse birth outcomes. Finally, propensity score matching (PSM) was applied to determine effectiveness of COC in maternal health services. Results Magnitude of adverse birth outcome was 26.8%: stillbirth (2.7%), neonatal mortality rate (3.1%) and neonatal morbidity (6.8%). Risk factors significantly associated were being poor household wealth index (AOR = 3.3), pregnant related complication during pregnancy (AOR = 3.29), labour and childbirth (AOR = 6.08), immediately after childbirth (AOR = 5.24), offensive odder amniotic fluid (AOR = 3.04) and history of stillbirth (AOR = 4.2). Whereas, women receive IFA during pregnancy (AOR = 0.44), initiate BF within 1hour (AOR = 0.22) and immunizing newborn within postnatal period (AOR = 0.33) were protective factors. As treatment effect, completion of COC in MHS via time dimension (β = -0.03), completion of key services of MHS (β = -0.04) and completion of COC in MHS via space dimension (β = -0.02) were associated with a significant reduction in the likelihood of perinatal death Conclusions The results suggested that neonatal and perinatal mortality rate were high as compared with national and international target. Completion of COC in MHS is an effective strategy in reduction perinatal death. Efforts should be made to strengthening COC of MHS and also encourage IFA supplementation, immunizing and early initiation of BF for newborn were strongly recommended.

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“…These rates are higher in high and middle-income countries, which likely reflect the lack of availability of NICUs in low-income countries. SMM significantly increases the odds of a fetal death in both HICs and LMICs [ 65 , 67 ]. Many of these adverse delivery outcomes are associated with the woman having preeclampsia and a need for delivery as her disease process progresses [ 43 , 68 ].…”

Section: Effects Of Smm On Delivery Outcomes and Infantsmentioning

confidence: 99%

A global view of severe maternal morbidity: moving beyond maternal mortality

et al. 2018

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BackgroundMaternal mortality continues to be of great public health importance, however for each woman who dies as the direct or indirect result of pregnancy, many more women experience life-threatening complications. The global burden of severe maternal morbidity (SMM) is not known, but the World Bank estimates that it is increasing over time. Consistent with rates of maternal mortality, SMM rates are higher in low- and middle-income countries (LMICs) than in high-income countries (HICs).Severe maternal morbidity in high-income countriesSince the WHO recommended that HICs with low maternal mortality ratios begin to examine SMM to identify systems failures and intervention priorities, researchers in many HICs have turned their attention to SMM. Where surveillance has been conducted, the most common etiologies of SMM have been major obstetric hemorrhage and hypertensive disorders. Of the countries that have conducted SMM reviews, the most common preventable factors were provider-related, specifically failure to identify “high risk” status, delays in diagnosis, and delays in treatment.Severe maternal morbidity in low and middle income countriesThe highest burden of SMM is in Sub-Saharan Africa, where estimates of SMM are as high as 198 per 1000 live births. Hemorrhage and hypertensive disorders are the leading conditions contributing to SMM across all regions. Case reviews are rare, but have revealed patterns of substandard maternal health care and suboptimal use of evidence-based strategies to prevent and treat morbidity.Effects of SMM on delivery outcomes and infantsSevere maternal morbidity not only puts the woman’s life at risk, her fetus/neonate may suffer consequences of morbidity and mortality as well. Adverse delivery outcomes occur at a higher frequency among women with SMM. Reducing preventable severe maternal morbidity not only reduces the potential for maternal mortality but also improves the health and well-being of the newborn.ConclusionIncreasing global maternal morbidity is a failure to achieve broad public health goals of improved women’s and infants’ health. It is incumbent upon all countries to implement surveillance initiatives to understand the burden of severe morbidity and to implement review processes for assessing potential preventability.

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Maternal Near Miss and Still birth in developing countries: A Systematic Review with Meta-Analysis

Cited by 4 publications

References 18 publications

The effects of completion of continuum of care in maternal health services on adverse birth outcomes in Northwestern Ethiopia: a prospective follow-up study

The effects of completion of continuum of care in maternal health services on adverse birth outcomes in Northwestern Ethiopia: a prospective follow-up study

Effects of continuum of care in maternal health services on adverse birth outcome in Northwest Ethiopia: a prospective follow up study

A global view of severe maternal morbidity: moving beyond maternal mortality

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