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BMC Pregnancy and Childbirth
Published in: BMC Pregnancy and Childbirth 1/2014

Open Access 01-12-2014 | Research article

Delays in receiving obstetric care and poor maternal outcomes: results from a national multicentre cross-sectional study

Authors: Rodolfo C Pacagnella, José G Cecatti, Mary A Parpinelli, Maria H Sousa, Samira M Haddad, Maria L Costa, João P Souza, Robert C Pattinson, the Brazilian Network for the Surveillance of Severe Maternal Morbidity study group

Published in: BMC Pregnancy and Childbirth | Issue 1/2014

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Abstract

Background

The vast majority of maternal deaths in low-and middle-income countries are preventable. Delay in obtaining access to appropriate health care is a fairly common problem which can be improved. The objective of this study was to explore the association between delay in providing obstetric health care and severe maternal morbidity/death.

Methods

This was a multicentre cross-sectional study, involving 27 referral obstetric facilities in all Brazilian regions between 2009 and 2010. All women admitted to the hospital with a pregnancy-related cause were screened, searching for potentially life-threatening conditions (PLTC), maternal death (MD) and maternal near-miss (MNM) cases, according to the WHO criteria. Data on delays were collected by medical chart review and interview with the medical staff. The prevalence of the three different types of delays was estimated according to the level of care and outcome of the complication. For factors associated with any delay, the PR and 95%CI controlled for cluster design were estimated.

Results

A total of 82,144 live births were screened, with 9,555 PLTC, MNM or MD cases prospectively identified. Overall, any type of delay was observed in 53.8% of cases; delay related to user factors was observed in 10.2%, 34.6% of delays were related to health service accessibility and 25.7% were related to quality of medical care. The occurrence of any delay was associated with increasing severity of maternal outcome: 52% in PLTC, 68.4% in MNM and 84.1% in MD.

Conclusions

Although this was not a population-based study and the results could not be generalized, there was a very clear and significant association between frequency of delay and severity of outcome, suggesting that timely and proper management are related to survival.
Appendix
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Metadata
Title
Delays in receiving obstetric care and poor maternal outcomes: results from a national multicentre cross-sectional study
Authors
Rodolfo C Pacagnella
José G Cecatti
Mary A Parpinelli
Maria H Sousa
Samira M Haddad
Maria L Costa
João P Souza
Robert C Pattinson
the Brazilian Network for the Surveillance of Severe Maternal Morbidity study group
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Pregnancy and Childbirth / Issue 1/2014
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/1471-2393-14-159

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