Key result
Severe maternal morbidity occurred in 34 per 1000 women and was independently associated with age >35, lacking a partner, parity extremes, and prior Caesarean section.
Cross-Sectional (n=97,095)
Yes
Maternal near miss, defined by severe complications such as ICU admission or organ failure, is associated with older age, parity extremes, and previous C-section, highlighting high-risk groups for targeted interventions.
Answers are grounded in this paper and cite their sources.
Highlights potential high-risk groups for maternal morbidity; leaves open whether targeted interventions improve outcomes.
OBJECTIVE: To develop an indicator of maternal near miss as a proxy for maternal death and to study its association with maternal factors and perinatal outcomes. METHODS: In a multicenter cross-sectional study, we collected maternal and perinatal data from the hospital records of a sample of women admitted for delivery over a period of two to three months in 120 hospitals located in eight Latin American countries. We followed a stratified multistage cluster random design. We assessed the intra-hospital occurrence of severe maternal morbidity and the latter's association with maternal characteristics and perinatal outcomes. FINDINGS: Of the 97,095 women studied, 2964 (34 per 1000) were at higher risk of dying in association with one or more of the following: being admitted to the intensive care unit (ICU), undergoing a hysterectomy, receiving a blood transfusion, suffering a cardiac or renal complication, or having eclampsia. Being older than 35 years, not having a partner, being a primipara or para > 3, and having had a Caesarean section in the previous pregnancy were factors independently associated with the occurrence of severe maternal morbidity. They were also positively associated with an increased occurrence of low and very low birth weight, stillbirth, early neonatal death, admission to the neonatal ICU, a prolonged maternal postpartum hospital stay and Caesarean section. CONCLUSION: Women who survive the serious conditions described could be pragmatically considered cases of maternal near miss. Interventions to reduce maternal and perinatal mortality should target women in these high-risk categories.
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Souza et al. (2010) conducted a cross-sectional in Severe maternal morbidity (maternal near miss) (n=97,095). Maternal risk factors (age > 35, no partner, primipara or para > 3, previous Caesarean section) vs. Absence of these risk factors was evaluated on Severe maternal morbidity (maternal near miss). Severe maternal morbidity occurred in 34 per 1000 women and was independently associated with age >35, lacking a partner, parity extremes, and prior Caesarean section.
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