Severe maternal morbidity in a general intensive care unit in Nigeria: clinical profiles and outcomes

Igbaruma, Solomon; Olagbuji, Biodun Nelson; Aderoba, Adeniyi Kolade; Kubeyinje, Weyinmi E.; Ande, B; Imarengiaye, CO

doi:10.1016/j.ijoa.2016.07.008

Cited by 8 publications

(12 citation statements)

References 22 publications

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“…One study contained data from six countries [ 21 ], with three sites in sub-Saharan Africa and four across India, Pakistan and Guatemala. The aim of this present review was to assess post-discharge risk among facility deliveries, however, two included studies used a combination of facility and home deliveries [ 21 , 24 ] and three did not specify delivery location [ 20 , 22 , 25 ].…”

Section: Resultsmentioning

confidence: 99%

“…Five studies focused on a general maternal population, while the remaining two studies targeted sub-populations: those diagnosed with and admitted for postpartum hemorrhage (PPH) (750 mL of blood loss or greater) after delivery [ 25 ], or those with an obstetric admission to the ICU anytime between 24 weeks gestation up to six weeks of delivery [ 24 ]. For the purpose of this review, only data among postpartum ICU admissions were reported.…”

Section: Resultsmentioning

confidence: 99%

“…Five studies enrolling between 95 and 384,461 women per study reported risk factors for postpartum mortality (Table 3 ) [ 13 , 21 , 23 – 25 ]. Three of these studies evaluated risk factors among a general maternal population [ 13 , 21 , 23 ], and the fourth and fifth study evaluated risk factors among a maternal population admitted to the ICU [ 24 ] and a population of women with postpartum hemorrhage [ 25 ], respectively.…”

Section: Resultsmentioning

confidence: 99%

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Risk factors for postpartum maternal mortality and hospital readmission in low- and middle-income countries: a systematic review

Symonds

Vidler

Wiens

et al. 2023

BMC Pregnancy Childbirth

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Background In low- and middle-income countries, approximately two thirds of maternal deaths occur in the postpartum period. Yet, care for women beyond 24 h after discharge is limited. The objective of this systematic review is to summarize current evidence on socio-demographic and clinical risk factors for (1) postpartum mortality and (2) postpartum hospital readmission. Methods A combination of keywords and subject headings (i.e. MeSH terms) for postpartum maternal mortality or readmission were searched. Articles published up to January 9, 2021 were identified in MEDLINE, EMBASE, and CINAHL databases, without language restrictions. Studies reporting socio-demographic or clinical risk factors for postpartum mortality or readmission within six weeks of delivery among women who delivered a livebirth in a low- or middle-income country were included. Data were extracted independently by two reviewers based on study characteristics, population, and outcomes. Included studies were assessed for quality and risk of bias using the Downs and Black checklist for ratings of randomized and non-randomized studies. Results Of 8783 abstracts screened, seven studies were included (total N = 387,786). Risk factors for postpartum mortality included Caesarean mode of delivery, nulliparity, low or very low birthweight, and shock upon admission. Risk factors for postpartum readmission included Caesarean mode of delivery, HIV positive serostatus, and abnormal body temperature. Conclusions Few studies reported individual socio-demographic or clinical risk factors for mortality or readmission after delivery in low- and middle-income countries; only Caesarean delivery was consistently reported. Further research is needed to identify factors that put women at greatest risk of post-discharge complications and mortality. Understanding post-discharge risk would facilitate targeted postpartum care and reduce adverse outcomes in women after delivery. Trial registration PROSPERO registration number: CRD42018103955.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Risk factors for postpartum maternal mortality and hospital readmission in low- and middle-income countries: a systematic review

Symonds

Vidler

Wiens

et al. 2023

BMC Pregnancy Childbirth

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“…Delirium can be caused by various causes, including sepsis, trauma, surgery, stress, and shock (Afonso et al, 2010;Bruce, Ritchie, Blizard, Lai, & Raven, 2007;de Jonghe et al, 2007;Koster, Oosterveld, Hensens, Wijma, & van der Palen, 2008;Tan et al, 2008 T A B L E 2 Receiver operating characteristic curve analyses for delirium among postpartum women in intensive care unit Igbaruma et al, 2016;Jonard, Ducloy-Bouthors, & Fourrier, 2016), and therefore such a group of patient is susceptible to delirium. In this study, incidence of delirium within 7 days after ICU entry was 20.6% among postpartum women.…”

Section: Discussionmentioning

confidence: 99%

Serum galectin‐3 levels and delirium among postpartum intensive care unit women

Zhu

et al. 2017

Brain and Behavior

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Objective: Inflammation correlates with delirium. Galectin-3 is a proinflammatory protein. This study aimed to determine relation of serum galectin-3 levels to delirium of postpartum intensive care unit (ICU) women. Materials and Methods:In this prospective observational study, serum galectin-3, S100B, and C-reactive protein levels of 412 postpartum ICU women and 412 healthy women were measured. Delirium and Acute Physiology and Chronic Health Care Evaluation II (APCHCE II) scores were recorded.Results: Serum levels of galectin-3, S100B, and C-reactive protein were significantly elevated in the postpartum women than in the healthy women. Galectin-3 levels were highly associated with APCHCE II scores and S100B and C-reactive protein levels.Galectin-3, C-reactive protein, and S100B levels and APCHCE II scores were identified as independent predictors for delirium. Area under the curve (AUC) of serum galectin-3 levels was similar to that of S100B levels, and significantly exceeded those of Creactive protein levels and APCHCE II scores. Moreover, galectin-3 significantly improved the AUCs of APCHCE II scores, S100B levels, and C-reactive protein levels. Conclusions:Galectin-3, involved in inflammatory process underlying delirium-related brain injury, might be a potential biomarker to predict delirium of postpartum ICU women. K E Y W O R D Sdelirium, galectin-3, intensive care unit, postpartum, women

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“…Higher rates of illiteracy among ICU maternity patients were described from 14.2% in Venezuela [54] to 55.8% in India [55], and 60.5% for 'uneducated' obstetric patients in Nigeria [56]. In India, Bajwa et al, (2010) [51] reported signi cantly higher rates of illiteracy (46%) in maternal ICU admissions; however, Gupta et al, (2011) [52] and Igbaruma et al, (2016) [49] did not nd signi differences in the maternal education rate between women with SAMM and maternal death cases admitted to an ICU in India and Nigeria, respectively. Poor educational attainment was a risk factor for maternal ICU admission in China [46] and women with higher education were less likely to be admitted to an ICU than obstetric patients without ICU admission, even though this was not shown in the logistic regression analysis in USA [37].…”

Section: Educationmentioning

confidence: 99%

Social determinants and exposure to intimate partner violence in women with severe acute maternal morbidity in the intensive care unit: a systematic review

Quintanilla

Taft

McDonald

et al. 2023

Preprint

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Background Studying severe acute maternal morbidity in the intensive care unit improves our understanding of potential factors affecting maternal health. Aim To review evidence on maternal exposure to intimate partner violence and social determinants of health in women with severe acute maternal morbidity in the intensive care unit. Methods The protocol for this review was registered in PROSPERO (registration number CRD42016037492). A systematic search was performed in MEDLINE, CINAHL, ProQuest, LILACS and SciELO using the search terms “intensive care unit”, “intensive care”, “critical care” and “critically ill” in combination with “intimate partner violence”, “social determinants of health”, “severe acute maternal morbidity”, pregnancy, postpartum and other similar terms. Eligible studies were i) quantitative, ii) published in English and Spanish, iii) from 2000 to 2021, iv) with data related to intimate partner violence and/or social determinants of health, and v) investigating severe acute maternal morbidity (maternity patients treated in the intensive care unit during pregnancy, childbirth or within 42 days of pregnancy termination). Of 52,866 studies initially identified, 1087 full texts were assessed and 156 studies included. Studies were independently assessed by two reviewers for screening, revision, quality assessment and abstracted data. Studies were categorised into high/middle/low-income countries and summarised data were presented using a narrative description, due to heterogenic data as: i) exposure to intimate partner violence and ii) social determinants of health. Results One study assessed intimate partner violence among mothers with severe acute maternal morbidity in the intensive care unit and found that women exposed to intimate partner violence before and during pregnancy had a nearly four-fold risk of severe acute maternal morbidity requiring ICU admission. Few social determinants of health other than age were reported in most studies. Conclusion This review identified a significant gap in knowledge concerning intimate partner violence and social determinants of health in women with severe acute maternal morbidity in the intensive care unit, which is essential to better understand the complete picture of the maternal morbidity spectrum and reduce maternal mortality.

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Severe maternal morbidity in a general intensive care unit in Nigeria: clinical profiles and outcomes

Cited by 8 publications

References 22 publications

Risk factors for postpartum maternal mortality and hospital readmission in low- and middle-income countries: a systematic review

Risk factors for postpartum maternal mortality and hospital readmission in low- and middle-income countries: a systematic review

Serum galectin‐3 levels and delirium among postpartum intensive care unit women

Social determinants and exposure to intimate partner violence in women with severe acute maternal morbidity in the intensive care unit: a systematic review

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