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ABSTRACT: Objective
To explore the incidence and factors associated with maternal near-miss.Design
Cross-sectional study with an embedded case-control study.Setting
Three tertiary referral hospitals in southern Ghana.Population
All women admitted to study facilities with pregnancy-related complications or for birth.Methods
An adapted version of the WHO Maternal Near Miss Screening Tool was used to identify maternal near-miss cases. These were compared with unmatched controls (uncomplicated deliveries) in a ratio of 1:2.Main outcome measures
Incidence of maternal near-miss, maternal near-miss to maternal mortality ratio, and cause of and factors associated with maternal near-miss.Results
Out of 8433 live births, 288 maternal near-miss cases and 62 maternal deaths were identified. In all, 454 healthy controls were recruited for comparison. Maternal near-miss and maternal death incidence ratios were 34.2 (95% CI 30.2-38.1) and 7.4 (95% CI 5.5-9.2) per 1000 live births, respectively with a maternal near-miss to mortality ratio of 4.6:1. Cause of near-miss was pre-eclampsia/eclampsia (41.0%), haemorrhage (12.2%), maternal sepsis (11.1%) and ruptured uterus (4.2%). A major factor associated with maternal near-miss was maternal fever within the 7 days before birth (OR 5.95, 95%CI 3.754-9.424). Spontaneous onset of labour was protective against near-miss (OR 0.09 95% CI 0.057-0.141).Conclusion
For every maternal death, there were nearly five maternal near-misses. Women having a fever in the 7 days before delivery were six times more likely to experience a near-miss than women not having fever.Tweetable abstract
Maternal near-miss exceeds maternal death by 5:1, with the leading cause of maternal near-miss was pre-eclampsia/eclampsia.
SUBMITTER: Oppong SA
PROVIDER: S-EPMC6459711 | biostudies-literature | 2019 May
REPOSITORIES: biostudies-literature
Oppong S A SA Bakari A A Bell A J AJ Bockarie Y Y Adu J A JA Turpin C A CA Obed S A SA Adanu R M RM Moyer C A CA
BJOG : an international journal of obstetrics and gynaecology 20190124 6
<h4>Objective</h4>To explore the incidence and factors associated with maternal near-miss.<h4>Design</h4>Cross-sectional study with an embedded case-control study.<h4>Setting</h4>Three tertiary referral hospitals in southern Ghana.<h4>Population</h4>All women admitted to study facilities with pregnancy-related complications or for birth.<h4>Methods</h4>An adapted version of the WHO Maternal Near Miss Screening Tool was used to identify maternal near-miss cases. These were compared with unmatched ...[more]