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BMC Pregnancy and Childbirth
Published in: BMC Pregnancy and Childbirth 1/2018

Open Access 01-12-2018 | Research article

Maternal near-miss and the risk of adverse perinatal outcomes: a prospective cohort study in selected public hospitals of Addis Ababa, Ethiopia

Authors: Ewnetu Firdawek Liyew, Alemayehu Worku Yalew, Mesganaw Fantahun Afework, Birgitta Essén

Published in: BMC Pregnancy and Childbirth | Issue 1/2018

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Abstract

Background

Presence of maternal near-miss conditions in women is strongly associated with the occurrence of adverse perinatal outcomes, but not well-understood in low-income countries. The study aimed to ascertain the effect of maternal near-miss on the risk of adverse perinatal outcomes in Ethiopia.

Methods

A prospective cohort study was conducted in five public hospitals of Addis Ababa, Ethiopia. Women admitted from May 1, 2015 to April 30, 2016 were recruited for the study. We followed a total of 828 women admitted for delivery or treatment of pregnancy-related complications along with their singleton newborn babies. Maternal near-miss was the primary exposure and was ascertained using the World Health Organization criteria. Women who delivered without complications were taken as the non-exposed groups. The main outcome was adverse perinatal outcomes. Data on maternal near-miss and perinatal outcomes were abstracted from medical records of the participants. Exposed and non-exposed women were interviewed by well-trained data collectors to obtain information about potential confounding factors. Logistic regressions were performed using Stata version 13.0 to determine the adjusted odds of adverse perinatal outcomes.

Results

A total of 207 women with maternal near-miss and 621 women with uncomplicated delivery were included in the study. After adjusting for potential confounders, women with maternal near-miss condition had more than five-fold increased odds of adverse perinatal outcomes compared to women who delivered without any complications (AOR = 5.69: 95% CI; 3.69–8.76). Other risk factors that were independently associated with adverse perinatal outcomes include: rural residence, history of prior stillbirth and primary educational level.

Conclusions

Presence of maternal near-miss in women is an independent risk factor for adverse perinatal outcomes. Hence, interventions rendered at improvement in maternal health of Ethiopia can lead to an improvement in perinatal outcomes.
Literature
1.
The World Health Organization [WHO]. Evaluating the quality of care for severe pregnancy complications. In: The WHO near-miss approach for maternal health. Geneva,Switzerland; 2011.
2.
Amaral E, Souza JP, Surita F, Luz AG, Sousa MH, Cecatti JG, Campbell O. A population-based surveillance study on severe acute maternal morbidity (near-miss) and adverse perinatal outcomes in Campinas, Brazil: the Vigimoma project. BMC Pregnancy and Childbirth. 2011;11(1)
3.
Jabir M, Abdul-Salam I, Suheil DM, Al-Hilli W, Abul-Hassan S, Al-Zuheiri A, Al-Ba’aj R, Dekan a, Tunçalp Ö, Souza JP. maternal near miss and quality of maternal health care in Baghdad, Iraq. BMC Pregnancy and Childbirth. 2013;13(1):1–9.CrossRef
4.
Morse ML, Fonseca SC, Gottgtroy CL, Waldmann CS, Gueller E. Severe maternal morbidity and near misses in a regional reference hospital. Rev Bras Epidemiol. 2011;14(2):310–22.CrossRefPubMed
5.
Adeoye IA, Onayade AA, Fatusi AO. Incidence, determinants and perinatal outcomes of near miss maternal morbidity in Ile-Ife Nigeria: a prospective case control study. BMC Pregnancy and Childbirth. 2013;13(1)
6.
Oliveira LC, Costa AA. Fetal and neonatal deaths among cases of maternal near miss. Rev Assoc Med Bras (1992). 2013;59(5):487–94.CrossRef
7.
Souza JP, Cecatti JG, Faundes A, Morais SS, Villar J, Carroli G, Gulmezoglu M, Wojdyla D, Zavaleta N, Donner A, et al. Maternal near miss and maternal death in the World Health Organization's 2005 global survey on maternal and perinatal health. Bulletin of the World Health Organization. 2010;88(2):113–9.CrossRefPubMed
8.
Liyew EF, Yalew AW, Afework MF, Essen B. Incidence and causes of maternal near-miss in selected hospitals of Addis Ababa, Ethiopia. PLoS One. 2017;12(6):e0179013.CrossRefPubMedPubMedCentral
9.
Liyew EF, Yalew AW, Afework MF, Essén B. Distant and proximate factors associated with maternal near-miss: a nested case-control study in selected public hospitals of Addis Ababa, Ethiopia. BMC Womens Health. 2018;18(1):28.CrossRefPubMedPubMedCentral
10.
Ness RB, Sibai BM. Shared and disparate components of the pathophysiologies of fetal growth restriction and preeclampsia. Am J Obstet Gynecol. 2006;195(1):40–9.CrossRefPubMed
11.
Gagnon R. Placental insufficiency and its consequences. European Journal of Obstetrics and Gynecology and Reproductive Biology. 110:S99–S107.
12.
Hutter D, Kingdom J, Jaeggi E. Causes and mechanisms of intrauterine hypoxia and its impact on the fetal cardiovascular system: a review. International Journal of Pediatrics. 2010;2010:9.CrossRef
13.
Hossain N, Khan N, Khan NH. Obstetric causes of stillbirth at low socioeconomic settings. J Pak Med Assoc. 2009;59(11):744–7.PubMed
14.
Lawn JE, Cousens S, Zupan J. 4 million neonatal deaths: when? Where? Why? Lancet. 2005;365(9462):891–900.CrossRefPubMed
15.
Hillemeier MM, Weisman CS, Chase GA, Dyer AM. Individual and community predictors of preterm birth and low birthweight along the rural-urban continuum in Central Pennsylvania. J Rural Health. 2007;23(1):42–8.CrossRefPubMed
16.
Berhie KA, Gebresilassie HG. Logistic regression analysis on the determinants of stillbirth in Ethiopia. Maternal health, neonatology and perinatology. 2016;2:10.CrossRefPubMedPubMedCentral
17.
Orvos H, Hoffmann I, Frank I, Katona M, Pál A, Kovács L. The perinatal outcome of pregnancy without prenatal care: a retrospective study in Szeged, Hungary. Eur J Obstet Gynecol Reprod Biol. 2002;100(2):171–3.CrossRefPubMed
18.
Ickovics JR, Kershaw TS, Westdahl C, Magriples U, Massey Z, Reynolds H, Rising SS. group prenatal care and perinatal outcomes: a randomized controlled trial. Obstet Gynecol. 2007;110(2 Pt 1):330–9.CrossRefPubMedPubMedCentral
19.
Agarwal K, Agarwal A, Agrawal V, Agrawal P, Chaudhary V. Prevalence and determinants of "low birth weight" among institutional deliveries. Annals of Nigerian Medicine. 2011;5(2):48–52.CrossRef
20.
Loto OM, Ezechi OC, Kalu BK, Loto A, Ezechi L, Ogunniyi SO. Poor obstetric performance of teenagers: is it age- or quality of care-related? J Obstet Gynaecol. 2004;24(4):395–8.CrossRefPubMed
21.
Harris DE, Aboueissa AM, Baugh N, Sarton C. Impact of rurality on maternal and infant health indicators and outcomes in Maine. Rural Remote Health. 2015;15(3):3278.PubMed
22.
Ouyang F, Zhang J, Betrán AP, Yang Z, Souza Jã P, Merialdi M. Recurrence of adverse perinatal outcomes in developing countries. Bull World Health Organ. 2013;91(5):357–67.CrossRefPubMedPubMedCentral
23.
Stringer EM, Vwalika B, Killam WP, Giganti MJ, Mbewe R, Chi BH, Chintu N, Rouse D, Goldenberg RL, Stringer JS. Determinants of stillbirth in Zambia. Obstet Gynecol. 2011;117(5):1151–9.CrossRefPubMed
24.
Watson-Jones D, Weiss HA, Changalucha JM, Todd J, Gumodoka B, Bulmer J, Balira R, Ross D, Mugeye K, Hayes R, et al. Adverse birth outcomes in United Republic of Tanzania--impact and prevention of maternal risk factors. Bull World Health Organ. 2007;85(1):9–18.CrossRefPubMedPubMedCentral
25.
McClure EM, Saleem S, Pasha O, Goldenberg RL. Stillbirth in developing countries: a review of causes, risk factors and prevention strategies. J Matern Fetal Neonatal Med. 2009;22(3):183–90.CrossRefPubMedPubMedCentral
26.
Feresu SA, Harlow SD, Woelk GB. Risk factors for prematurity at Harare maternity hospital, Zimbabwe. Int J Epidemiol. 2004;33(6):1194–201.CrossRefPubMed
27.
Anand K, Garg B. A study of factors affecting LBW. Indian J Community Med. 2000;6
28.
Chakraborty N, Islam MA, Chowdhury RI, Bari W, Akhter HH. Determinants of the use of maternal health services in rural Bangladesh. Health Promot Int. 2003;18(4):327–37.CrossRefPubMed
29.
Luo Z-C, Wilkins R, Kramer MS, Fetal, System IHSGotCPS. effect of neighbourhood income and maternal education on birth outcomes: a population-based study. Can Med Assoc J. 2006;174(10):1415–20.CrossRef
30.
Silveira MF, Victora CG, Barros AJ, Santos IS, Matijasevich A, Barros FC. Determinants of preterm birth: Pelotas, Rio Grande do Sul state, Brazil, 2004 birth cohort. Cadernos de saude publica. 2010;26(1):185–94.CrossRefPubMed
31.
32.
World Health Organization: Standards for improving quality of maternal and newborn care in health facilities. In. Geneva; 2016.
Metadata
Title
Maternal near-miss and the risk of adverse perinatal outcomes: a prospective cohort study in selected public hospitals of Addis Ababa, Ethiopia
Authors
Ewnetu Firdawek Liyew
Alemayehu Worku Yalew
Mesganaw Fantahun Afework
Birgitta Essén
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Pregnancy and Childbirth / Issue 1/2018
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/s12884-018-1983-y

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