Proportion of Maternal Near-Miss and Its Determinants among Northwest Ethiopian Women: A Cross-Sectional Study

Abstract

Background. Life-threatening situations might arise unexpectedly during pregnancy. Maternal near-miss can be a proxy for maternal death and explained as women who nearly died due to obstetric-related complications. It is recognized as the predictor of level of care and maternal death. Maternal near-miss evaluates life-threatening pregnancy-related complications, and it directs the assessment of the quality of obstetric care. Objective. To determine the proportion and factors associated with maternal near-miss at maternity wards at the University of Gondar Referral Hospital, Northwest Ethiopia, 2019. Methods. A cross-sectional study design was carried out from March 1 to June 20, 2019, using WHO criteria for maternal near-miss at the University of Gondar Referral Hospital. The data are from the interviews and review of 303 systematically selected participants’ medical files at maternity wards. Bivariate and multivariable logistic regression analyses were performed to analyze factors associated with maternal near-miss, including estimation of crude and adjusted odds ratios and their respective 95% confidence intervals and p value less than 0.05 through SPSS version 20. Result. The study revealed that the proportion of maternal near-miss was found to be 15.8% (95%CI=11.9%-20.1%). In the adjusted analyses, maternal near-miss was significantly associated with low (≤1000 ETB) monthly income (AOR=399; 95%CI=1.65, 9.65), seven or more days of hospital stay (AOR=5.43; 95%CI=2.49, 11.83), vaginal bleeding (AOR=2.75, 95%CI=1.17, 6.47), and pregnancy-induced hypertension (AOR=5.13; 95%CI=2.08, 12.6). Conclusion and Recommendation. The near-miss proportion was comparable to that in the region. Associated factors were low monthly income, seven or more days of hospital stay, vaginal bleeding, and pregnancy-induced hypertension. Thus, giving attention on early identification and treatment of these potential factors can be the opportunity in the reduction of maternal morbidity and mortality.

Determinants of maternal near miss events among women admitted to tertiary hospitals in Mogadishu, Somalia: a facility-based case–control study

“…Moreover, the study has revealed that the odds of developing maternal near-miss events among women with family income of less than 100 USD were 3.33 times more compared to those with more than 500 USD [OR = 3.333, 95%CI = (1.055-10.530)]. The result of this study was consistent with other study conducted in Ethiopia a year ago divulged that women with the lowest monthly income (1000 ETB) had 3.99 times the chance of having maternal near-miss than those with a monthly income more than or equal to 3001 ETB [30]. This is not surprising since over 99% of maternal deaths occur in low-and middle-income countries due to extreme poverty resulting in lack of access to quality healthcare and education of women [2].…”

Maternal Third Delay and Associated Factors among Women Admitted for Emergency Obstetric Care in Public Hospitals in Sidama Regional State, Ethiopia

“…Based on women reports of their reason for experiencing delay in receiving care, staff workload 75 (47.2%), lengthy admission process 35 (22%), health professionals negligence 27 (17%), lack of supply or drugs 23 (14.5%), delay in providing informed consent 3 (1.9%) and unfunctional operating room 2(1.3%) were stated. These findings were also identified as a reason for maternal third delay in a cross-sectional study conducted in Brazil [ 30 ], University of Gondar Referral Hospital [ 31 ], Arsi Zone [ 26 ], and a multicountry study done in seven countries [ 10 ].…”

Maternal near-miss and mortality in a teaching hospital in Tigray region, Northern Ethiopia

“… 24 , 25 However, the MNM ratio in this study was nearly 3.5 times higher than the MNM ratio of an 8.01 per 1000 live births described in a facility-based cross-sectional study conducted in the capital, Addis Ababa 26 and nearly two times higher than a similar study conducted in University of Gondar Referral Hospital, a similar setup in Northwest Ethiopia. 27 …”