Measuring maternal health: focus on maternal morbidity

Firoz, Tabassum; Chou, Doris; Dadelszen, Peter von; Agrawal, Priya; Vanderkruik, Rachel; Tunçalp, Özge; Magee, Laura A.; Broek, Nynke van den; Say, Lale

doi:10.2471/blt.13.117564

Cited by 225 publications

(244 citation statements)

References 10 publications

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“…Our study whose results are consistent with suggested pathways is thus the first one supporting that stress-related morbidity during pregnancy involves offspring as well as mother. For those planning to promote maternal health, this finding is expected to redeem prevention or mitigation of maternal adverse outcomes, including hypertensive disorders and infection (generated by stress or not), two of major causes of mortality [13].…”

Section: Discussionmentioning

confidence: 99%

Maternal Stress and Pregnancy Outcomes

Tandu-Umba¹,

Dedetemo²,

Mananga³

2014

OJOG

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Aims of the study: To seek for magnitude of stress conditions among pregnant women, the clinical profile of stressed pregnant women and the potential of stress on adverse maternal and perinatal outcomes in Kinshasa. Methods: This is a multicentre 6-month case-control study dealing with consenting women having given birth at 13 biggest maternities of Kinshasa, the capital of DR Congo. Mother-infant pairs were considered cases (obviously stressed women) and controls (light or not stressed women) at the end of data processing according to their perceived stress scores (PSS). Stress events, potential stress factors and maternal general and physical characteristics were registered along with maternal and perinatal outcomes. Odds ratios calculation allowed finding influence of stress on occurrence of adverse outcomes. Results and conclusions: Our study concerned 1082 women whose 57.1% (n = 618) qualified as the stressed. General characteristics found significantly different between stressed and non-stressed women were marital status (the married and widowed more frequent among the stressed), instruction level (the educated more frequent among the stressed), socioeconomic status (the elevated more frequent among the stressed) and religion status (both the traditional and new charismatic more frequent among the stressed). Obstetric risk factors were similar in both groups that were different only according to stress factors, whether emotional (relationships) or pregnancy (preciousness) related. The 3 most prominent stress factors were parent's death (p 0.000), tension in family (p 0.000) and tension in couple (p 0.003). All expectedly compensating factors appeared significantly more frequent among stressed women. As of organic pregnancy outcomes infection, gastritis, hypertensive disorders and preterm labor were maternal ones significantly more frequent among stressed women. All non-organic outcomes (insomnia and depression) were significantly predominant among stressed women. In offspring, prematurity, low birth weight and perinatal death were significantly dominant among those born to stressed women. Odds ratios calculation showed significant potential of stress conditions on occurrence of all maternal complications but cesarean section. In * This study was approved by the scientific board of the faculty of medicine (University of Kinshasa). # Corresponding author.B. Tandu-Umba et al. 362offspring too, risk of outcomes' occurrence was enhanced by stress, except for macrosomia and neonatal distress.

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Section: Discussionmentioning

confidence: 99%

Maternal Stress and Pregnancy Outcomes

Tandu-Umba¹,

Dedetemo²,

Mananga³

2014

OJOG

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“…The WHO has proposed a definition and a measurement approach for maternal near-miss (i.e., ''a woman who nearly died but survived a complication that occurred during pregnancy, childbirth or within 42 days of termination of pregnancy''), 16 and recently organized a working group to develop a definition and propose a measurement strategy for a larger group of severe maternal morbidities. 17 The EURO-PERISTAT project uses a maternal morbidity indicator that includes any one of eclampsia, hysterectomy, embolization, blood transfusion, or a stay of more than 24 hours in an intensive care unit. 10 By and large, there are three approaches for identifying severe morbidity using either disease-specific criteria to capture conditions like eclampsia or hemorrhage, management criteria to identify interventions like massive blood transfusion or hysterectomy, or organ-system dysfunction criteria to identify the dysfunction or failure of organs and systems.…”

Section: Severe Maternal Morbidity In the United Statesmentioning

confidence: 99%

Maternal Mortality and Morbidity in the United States: Where Are We Now?

Creanga

Berg

et al. 2014

Journal of Women's Health

352

272

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This article provides a brief overview of the work conducted by the Division of Reproductive Health at the Centers for Disease Control and Prevention on severe maternal morbidity and mortality in the United States. The article presents the latest data and trends in maternal mortality and severe maternal morbidity, as well as on maternal substance abuse and mental health disorders during pregnancy, two relatively recent topics of interest in the Division, and includes future directions of work in all these areas.

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“…Em 2015, foi estimada a ocorrência de 303 mil óbitos maternos 1 , 2,6 milhões de óbitos fetais 2 , 2,7 milhões de óbitos neonatais 3 no mundo. Com a redução da mortalidade materna 1 maior ênfase tem sido dada às morbidades 4 na avaliação da saúde materna. Há distintas definições para complicações maternas durante a gestação, e esforços têm sido dedicados para a formulação de indicadores que possam reproduzir a magnitude de sua ocorrência no mundo 5 .…”

Section: Introductionunclassified

Internações por complicações obstétricas na gestação e desfechos maternos e perinatais, em uma coorte de gestantes no Sistema Único de Saúde no Município de São Paulo, Brasil

et al. 2018

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A morbidade materna, a mortalidade neonatal e a mortalidade fetal são importantes indicadores da saúde materna infantil. O estudo tem por objetivo descrever desfechos maternos e perinatais (baixo peso ao nascer, prematuridade, óbito fetal e neonatal, internações pós-parto e readmissão dos recém-nascidos) de uma coorte de gestantes cujos partos foram financiados pelo Sistema Único de Saúde (SUS) no Município de São Paulo, Brasil, no segundo semestre de 2012. Foi obtida uma coorte retrospectiva de 55.404 gestantes com vinculação (determinística e probabilística) das informações do Sistema de Informações Hospitalares do SUS (SIH/SUS), Sistema de Informações sobre Nascidos Vivos (SINASC), Sistema de Informações sobre Mortalidade (SIM) e Cadastro Nacional de Estabelecimentos de Saúde (CNES). Internações por complicações obstétricas da gestação ocorreram em 4,3% das gestantes. Diagnósticos mais frequentes foram: infecções, doenças hipertensivas e diabetes. As internações prévias ao parto foram mais frequentes nas gestantes a partir de 35 anos, de gestações múltiplas e com baixa escolaridade. As internações das gestantes no pós-parto foram 3 vezes maior e a mortalidade materna 9 vezes maior entre as gestantes com internação prévia por complicações obstétricas. Os desfechos perinatais (mortalidade fetal e neonatal, prematuridade e baixo peso ao nascer) foram 2 vezes mais frequentes entre os conceptos de gestantes com internação prévia que aquelas sem internação. Comportamento semelhante foi encontrado com relação à internação dos recém-nascidos logo após o parto e na readmissão hospitalar. Desfechos maternos e perinatais negativos foram mais frequentes em gestantes com internação prévia ao parto.

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Measuring maternal health: focus on maternal morbidity

Cited by 225 publications

References 10 publications

Maternal Stress and Pregnancy Outcomes

Maternal Stress and Pregnancy Outcomes

Maternal Mortality and Morbidity in the United States: Where Are We Now?

Internações por complicações obstétricas na gestação e desfechos maternos e perinatais, em uma coorte de gestantes no Sistema Único de Saúde no Município de São Paulo, Brasil

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