Incidência do near miss materno no parto e pós-parto hospitalar: dados da pesquisa Nascer no Brasil

Abstract

This study evaluated data on the incidence of maternal near miss identified on World Health Organization (WHO) criteria from the Birth in Brazil survey. The study was conducted between February 2011 and October 2012. The results presented are estimates for the study population (2,337,476 births), based on a sample of 23,894 women interviewed. The results showed an incidence of maternal near miss of 10.21 per 1,000 live births and a near-miss-to-mortality ratio of 30.8 maternal near miss to every maternal death. Maternal near miss was identified most prevalently by clinical criteria, at incidence of 5.2 per 1,000 live births. Maternal near miss was associated with maternal age 35 or more years (RR=1.6; 95%CI: 1.1-2.5), a history of previous cesarean delivery (RR=1.9; 95%CI: 1.1-3.4) and high-risk pregnancy (RR=4.5; 95%CI: 2.8-7.0). incidence of maternal near miss was also higher at hospitals in capital cities (RR=2.2; 95%CI: 1.3-3.8) and those belonging to Brazil's national health service, the Brazilian Unified National Health System (SUS) (RR=3.2; 95%CI: 1.6-6.6). Improved quality of childbirth care services can help reduce maternal mortality in Brazil.

Concepts, prevalence and characteristics of severe maternal morbidity and near miss in Brazil: a systematic review

“…"Born in Brazil" research was a hospital based study covering all the Brazilian regions, including only hospitals with more than 500 childbirths per year and excluding cases of abortion and hospitalization during pregnancy which was not the main goal of this study. 5 As most births in Brazil occur in a hospital environment, this study could be considered as a population study approach, except for the above limitations. Their results, consistent with those studies at the local level have a great relevance for guiding health policies.…”

“…5 The sample had 243 maternal near miss cases with an estimated 23,747 occurrences of maternal near miss in the Country, resulting in an incidence of 10.2/1,000 live births. 5 The incidence of maternal near miss was higher in women over 35 years of age, low schooling, previous cesarean history, complications during pregnancy, without prenatal care and with current cesarean section. Factors associated to statistical significance were: absence of prenatal care, obstetric complications, cesarean section and pilgrimage before the delivery.…”

“…The latter two reflect the effectiveness on care in preventing a severe case evolving in death, and expecting a high MNM: MD and a low MR. 3 In addition to women's commitment, severe maternal morbidity/maternal near miss has an impact on fetal and neonatal outcomes, including neonatal near miss. 5 We have not identified reviews on severe maternal morbidity/near miss in Brazil, and the most recent international review published in 2013, included a few Brazilian studies. 6 Considering this gap and the relevance that deaths and other maternal outcomes such as abortion, hypertensive diseases, hemorrhages and infections have an effect on women and children's health, the objective of this article was to review Brazilian medical literature on maternal near miss.…”

Memórias coletivas de mulheres que vivenciaram o near miss materno: necessidades de saúde e direitos humanos

“…datasus.gov.br/DATASUS/index.php?area=02, acessado em 06/Mai/2015) 6 . Recente inquérito realizado no país identificou a incidência de 10,2 casos de near miss para cada mil nascidos vivosvalor três vezes maior do que aqueles observados em países da Europa 7 .…”

Near Miss materno como indicador de atenção à saúde: uma revisão integrativa

“…Nessa construção propositiva, a Organização Mundial da Saúde (OMS) estima que, em 2010, 287 mil mulheres no mundo morreram durante a gestação e o parto. Apesar da redução de 47% em relação ao ano de 1990, esse índice está distante da meta de redução de 75% das mortes maternas até 2015 (2) . A morte materna advinda de uma gestação normal não é um fato isolado.…”