NDLI: Maternal near miss and death among women with severe hypertensive disorders: a Brazilian multicenter surveillance study

Content Provider	Springer Nature : BioMed Central
Author	Zanette, Elvira Parpinelli, Mary Angela Surita, Fernanda Garanhani Costa, Maria Laura Haddad, Samira Maerrawi Sousa, Maria Helena e Silva, Joao Luiz Pinto Souza, Joao Paulo Cecatti, Jose Guilherme
Abstract	Background Hypertensive disorders represent the major cause of maternal morbidity in middle income countries. The main objective of this study was to identify the prevalence and factors associated with severe maternal outcomes in women with severe hypertensive disorders. Methods This was a cross-sectional, multicenter study, including 6706 women with severe hypertensive disorder from 27 maternity hospitals in Brazil. A prospective surveillance of severe maternal morbidity with data collected from medical charts and entered into OpenClinica®, an online system, over a one-year period (2009 to 2010). Women with severe preeclampsia, severe hypertension, eclampsia and HELLP syndrome were included in the study. They were grouped according to outcome in near miss, maternal death and potentially life-threatening condition. Prevalence ratios and 95% confidence intervals adjusted for cluster effect for maternal and perinatal variables and delays in receiving obstetric care were calculated as risk estimates of maternal complications having a severe maternal outcome (near miss or death). Poisson multiple regression analysis was also performed. Results Severe hypertensive disorders were the main cause of severe maternal morbidity (6706/9555); the prevalence of near miss was 4.2 cases per 1000 live births, there were 8.3 cases of Near Miss to 1 Maternal Death and the mortality index was 10.7% (case fatality). Early onset of the disease and postpartum hemorrhage were independent variables associated with severe maternal outcomes, in addition to acute pulmonary edema, previous heart disease and delays in receiving secondary and tertiary care. Conclusions In women with severe hypertensive disorders, the current study identified situations independently associated with a severe maternal outcome, which could be modified by interventions in obstetric care and in the healthcare system. Furthermore, the study showed the feasibility of a hospital system for surveillance of severe maternal morbidity.
Related Links	https://reproductive-health-journal.biomedcentral.com/counter/pdf/10.1186/1742-4755-11-4.pdf
Ending Page	11
Page Count	11
Starting Page	1
File Format	HTM / HTML
ISSN	17424755
DOI	10.1186/1742-4755-11-4
Journal	Reproductive Health
Issue Number	1
Volume Number	11
Language	English
Publisher	BioMed Central
Publisher Date	2014-01-16
Access Restriction	Open
Subject Keyword	Reproductive Medicine Public Health Maternal and Child Health Organ dysfunction Organ failure Severe preeclampsia Eclampsia Maternal mortality Maternal morbidity
Content Type	Text
Resource Type	Article
Subject	Obstetrics and Gynecology Reproductive Medicine
Journal Impact Factor	3.6/2023
5-Year Journal Impact Factor	4/2023

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