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Int J Gynaecol Obstet. 2017 Sep;138(3):347-355. doi: 10.1002/ijgo.12219. Epub 2017 Jun 13.

Maternal near miss in low-resource areas.

Author information

1
Department of Obstetrics and Gynecology, Columbia University School of Medicine, New York, NY, USA.
2
Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan.
3
Social, Statistical and Environmental Health Sciences, RTI International, Durham, NC, USA.
4
School of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of the Congo.
5
Department of Pediatrics, University of Zambia, Lusaka, Zambia.
6
Maternal and Child Health, INCAP, Guatemala City, Guatemala.
7
Jawaharlal Nehru Medical Center, KLE University, Belagavi, India.
8
Lata Medical Research Foundation, Nagpur, India.
9
School of Medicine, Moi University, Eldoret, Kenya.
10
Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
11
Department of Pediatrics, University of Colorado, Denver, CO, USA.
12
School of Global Public Health, Thomas Jefferson University, Philadelphia, PA, USA.
13
School of Global Health, Boston University, Boston, MA, USA.
14
Department of Pediatrics, Indiana University, Indianapolis, IN, USA.
15
IECS University of Buenos Aires, Buenos Aires, Argentina.
16
Perinatology and Pregnancy Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, MD, USA.
17
Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL, USA.
18
Department of Pediatrics, Cincinnati Hospital for Children, Cincinnati, OH, USA.

Abstract

OBJECTIVE:

To describe the Global Network Near-Miss Maternal Mortality System and its application in seven sites.

METHODS:

In a population-based study, pregnant women eligible for enrollment in the Maternal and Newborn Health Registry at seven sites (Democratic Republic of the Congo; Guatemala; Belagavi and Nagpur, India; Kenya; Pakistan; and Zambia) between January 2014 and April 2016 were screened to identify those likely to have a near-miss event. The WHO maternal near-miss criteria were modified for low-resource settings. The ratio of near-miss events to maternal deaths was calculated.

RESULTS:

Among 122 707 women screened, 18 307 (15.0%) had a potential near-miss event, of whom 4866 (26.6%; 4.0% of all women) had a near-miss maternal event. The overall maternal mortality ratio was 155 per 100 000 live births. The ratio of near-miss events to maternal deaths was 26 to 1. The most common factors involved in near-miss cases were the hematologic/coagulation system, infection, and cardiovascular system.

CONCLUSION:

By using the Global Network Near-Miss Maternal Mortality System, large numbers of women were screened for near-miss events, including those delivering at home or a low-level maternity clinic. The 4.0% incidence of near-miss maternal mortality is similar to previously reported data. The ratio of 26 near-miss cases to 1 maternal death suggests that near miss might evaluate the impact of interventions more efficiently than maternal mortality.

KEYWORDS:

Low- and middle-income countries; Maternal mortality; Maternal near miss

PMID:
28513837
PMCID:
PMC5603206
DOI:
10.1002/ijgo.12219
[Indexed for MEDLINE]
Free PMC Article

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