Factors associated with severe maternal morbidity and near miss in the São Francisco Valley, Brazil: a retrospective, cohort study.
BMC Pregnancy Childbirth
; 14: 91, 2014 Feb 27.
Article
em En
| MEDLINE
| ID: mdl-24576223
ABSTRACT
BACKGROUND:
Maternal mortality remains a major public health issue worldwide, with persistent high rates prevailing principally in underdeveloped countries. The objective of this study was to determine the risk factors for severe maternal morbidity and near miss (SMM/NM) in pregnant and postpartum women at the maternity ward of the Dom Malan Hospital, Petrolina, in northeastern Brazil.METHODS:
A retrospective, cohort study was conducted to evaluate the sociodemographic and obstetric characteristics of the women. Patients who remained hospitalized at the end of the study period were excluded. Risk ratios (RR) and their respective 95% confidence intervals (95% CI) were calculated as a measure of relative risk. Hierarchical multiple logistic regression was also performed. Two-tailed p-values were used for all the tests and the significance level adopted was 5%.RESULTS:
A total of 2,291 pregnant or postpartum women receiving care between May and August, 2011 were included. The frequencies of severe maternal morbidity and near miss were 17.5% and 1.0%, respectively. Following multivariate analysis, the factors that remained significantly associated with an increased risk of SMM/NM were a Cesarean section in the current pregnancy (OR 2.6; 95% CI 2.0 - 3.3), clinical comorbidities (OR 3.4; 95% CI 2.5 - 4.4), having attended fewer than six prenatal visits (OR 1.1; 95% CI 1.01 - 1.69) and the presence of the third delay (i.e. delay in receiving care at the health facility) (OR 13.3; 95% CI 6.7 - 26.4).CONCLUSIONS:
The risk of SMM/NM was greater in women who had been submitted to a Cesarean section in the current pregnancy, in the presence of clinical comorbidities, fewer prenatal visits and when the third delay was present. All these factors could be minimized by initiating a broad debate on healthcare policies, introducing preventive measures and improving the training of the professionals and services providing obstetric care.
Texto completo:
1
Coleções:
01-internacional
Contexto em Saúde:
2_ODS3
Base de dados:
MEDLINE
Assunto principal:
Complicações na Gravidez
/
População Urbana
Tipo de estudo:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Aspecto:
Determinantes_sociais_saude
Limite:
Adult
/
Female
/
Humans
/
Pregnancy
País/Região como assunto:
America do sul
/
Brasil
Idioma:
En
Revista:
BMC Pregnancy Childbirth
Ano de publicação:
2014
Tipo de documento:
Article