Adverse perinatal outcomes are associated with severe maternal morbidity and mortality: evidence from a national multicentre cross-sectional study

Zanardi, Dulce M.; Parpinelli, Mary Ângela; Haddad, Samira M.; Costa, Maria Laura; Sousa, Maria Helena de; Leite, Débora Farias Batista; Cecatti, José Guilherme

doi:10.1007/s00404-018-5004-1

Cited by 31 publications

(31 citation statements)

References 35 publications

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“…The common pathways to severe maternal and perinatal outcomes are potential areas of intervention for addressing the needs of both women and newborns [6]. Factors associated with adverse perinatal outcomes in this study (antepartum hemorrhage, lack of prenatal care) were comparable with findings from previous studies in Uganda [32], Nigeria [33], the Gambia [34], and Brazil [35]. We found that perinatal deaths were higher in absolute numbers among women in the SSA MNM group.…”

Section: Viewpoints Paperssupporting

confidence: 82%

Surviving mothers and lost babies – burden of stillbirths and neonatal deaths among women with maternal near miss in eastern Ethiopia: a prospective cohort study

Tura¹,

Scherjon²,

Roosmalen³

et al. 2020

Journal of Global Health

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Background Although maternal near miss (MNM) is often considered a 'great save' because the woman survived life-threatening complications, these complications may have resulted in loss of a child or severe neonatal morbidity. The objective of this study was to assess proportion of perinatal mortality (stillbirths and early neonatal deaths) in a cohort of women with MNM in eastern Ethiopia. In addition, we compared perinatal outcomes among women who fulfilled the World Health Organization (WHO) and the sub-Saharan African (SSA) MNM criteria. Methods In a prospective cohort design, women with potentially life-threatening conditions (PLTC) (severe postpartum hemorrhage, severe pre-(eclampsia), sepsis/severe systemic infection, and ruptured uterus) were identified every day from January 1st, 2016, to April 30th, 2017, and followed until discharge in the two main hospitals in Harar, Ethiopia. Maternal and perinatal outcomes were collected using both sets of criteria. Numbers and proportions of stillbirths and early neonatal deaths were computed and compared.

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Section: Viewpoints Paperssupporting

confidence: 82%

Surviving mothers and lost babies – burden of stillbirths and neonatal deaths among women with maternal near miss in eastern Ethiopia: a prospective cohort study

Tura¹,

Scherjon²,

Roosmalen³

et al. 2020

Journal of Global Health

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“…Mixed association existed between hemorrhage and hypertensive disorder during pregnancy and NNM in southern Ethiopia [26] and Brazil [23]. In support of the current study, there existed an association between MNM and higher rates of adverse perinatal outcome born to these mothers [45,57,65,66]. Tura et al claim that adverse perinatal outcomes among MNM women is self-evident given the fact that MNM are identi ed using severe clinical criteria along with organ disfunction, which was also supported by their ndings [28].…”

Section: Discussionsupporting

confidence: 84%

Prevalence of neonatal near miss and associated factors in Nepal: a cross-sectional study

Rajbanshi

Hussain

2020

Preprint

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Background: Unlike the infant mortality rate, the rate of neonatal mortality has not declined and remains a major health challenge in the low- and middle-income countries. There is an urgent need to focus on newborn care, especially during the first 24 hours after birth and the early neonatal period. Neonatal near miss (NNM) is an emerging concept similar to that of maternal near miss. NNM events occur three to eight times more often than the neonatal deaths. The objective of this study was to establish the prevalence of NNM and identify its associated factors. Methods: A hospital-based cross-sectional study was conducted at Koshi Hospital, Morang district, Nepal. Neonates and their mothers of unspecified maternal age and number of gestational weeks were enrolled. The key inclusion criterion was the pragmatic and management markers of NNM, and admission of newborn infants to the neonatal intensive care unit (NICU) in Koshi Hospital. Non-Nepali citizens were excluded. Consecutive sampling was used until the required sample size of 1,000 newborn infants was reached. Simple and multiple logistic regression analysis was performed using SPSS® version 24.0.Results: One thousand respondents were recruited. The prevalence of NNM was 79 per 1,000 live births. Severe maternal morbidity (adjusted odds ratio (AOR): 4.51, 95% confidence interval (CI): 2.07–9.84), maternal secondary (AOR: 0.46, 95% CI: 0.24–0.88) and tertiary education (AOR: 0.18, 95% CI: 0.05–0.56), multiparity (AOR: 0.52, 95% CI: 0.39–0.86), and caesarean section (AOR: 0.48, 95% CI: 0.19–0.99) were associated with NNM. Conclusions: The prevalence of NNM in Nepal was 7.9%. Mothers’ obstetric factors, maternal complications and education were associated with NNM. Referral hospitals should have safer access to caesarean section and be prepared to offer NICU intervention to save mothers and their newborns.

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“…Previous studies indicated that SMO is higher among older women and also more associated with adverse perinatal outcomes [37][38][39]. e current study went further and revealed that women (20 years and above) were more likely to have poor perinatal outcomes (perinatal mortality) compared to younger women (less than 20 years).…”

Section: Discussionmentioning

confidence: 49%

“…Of these deaths, 66% are contributed by sub-Saharan Africa (SSA) alone [5]. Recent research studies conducted in Tanzania highlighted a notable surge of maternal mortality ratio (MMR) (from 454 to 556 maternal deaths per 100 000 live births), while perinatal mortality ratio (PMR) slightly increased (36)(37)(38)(39) perinatal deaths per 1000 all total births) between 2010 and 2016 [6,7]. is incremental is related to some deficiencies in recognizing and managing obstetric complications that range from minor morbidity to lifethreatening conditions which need attention [8,9].…”

Section: Introductionmentioning

confidence: 99%

Incidence and Predictors of Maternal and Perinatal Mortality among Women with Severe Maternal Outcomes: A Tanzanian Facility-Based Survey for Improving Maternal and Newborn Care

Lilungulu

Bintabara

Mujungu

et al. 2020

Obstetrics and Gynecology International

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Introduction. Maternal and perinatal mortality is still a major public health challenge in Tanzania, despite the ongoing government efforts to improve maternal and newborn care. Among the contributors to these problems is the high magnitude of severe maternal outcomes (maternal near-miss). The current study, therefore, aimed to identify the magnitude and predictors of maternal and perinatal mortality among women with severe maternal outcomes admitted to Dodoma Regional Referral Hospital. Methods. A retrospective cross-sectional study was conducted from October 2015 to January 2016 at Dodoma Regional Referral Hospital in Dodoma City. All maternal deaths and maternal near-misses based on WHO criteria were included in this study. Three outcome variables have been identified: maternal mortality, perinatal mortality, and neonatal complications. To examine the predictors for the three predetermined outcome variables, the three logit models each containing unadjusted and adjusted findings were fitted. A P-value less than 0.05 was considered indicative of statistically significant. Results. A total of 3600 pregnant women were admitted for obstetric reasons during the mentioned period. 140 of them were diagnosed with severe maternal outcomes; hence, they were included in this study. The severe maternal outcome incidence ratio was 40.23 per 1000 live births, the institutional maternal mortality ratio was 459.77 per 100000 live births, and the perinatal mortality rate was 10.83 per 1000 total births. Most of the maternal morbidity and mortality were due to direct causes in which postpartum hemorrhage and hypertensive disorders were the leading causes. In adjusted analysis, per-protocol management, maternal age, and mode of birth were predictors of maternal mortality, perinatal mortality, and neonatal complications, respectively. Conclusion. Establishing and strengthening obstetric ICUs will help reduce maternal mortality as the response time from the onset of obstetric complications, while the provision of high-quality care will be substantially reduced. Furthermore, the study recommends regular provision of in-service refresher training to emphasize the practice and compliance of per-protocol case management through a team approach in order to reduce the burden of maternal and perinatal mortality in Tanzania.

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Adverse perinatal outcomes are associated with severe maternal morbidity and mortality: evidence from a national multicentre cross-sectional study

Cited by 31 publications

References 35 publications

Surviving mothers and lost babies – burden of stillbirths and neonatal deaths among women with maternal near miss in eastern Ethiopia: a prospective cohort study

Surviving mothers and lost babies – burden of stillbirths and neonatal deaths among women with maternal near miss in eastern Ethiopia: a prospective cohort study

Prevalence of neonatal near miss and associated factors in Nepal: a cross-sectional study

Incidence and Predictors of Maternal and Perinatal Mortality among Women with Severe Maternal Outcomes: A Tanzanian Facility-Based Survey for Improving Maternal and Newborn Care

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