Rosendo Tatyana Maria Silva de Souza, Roncalli Angelo Giuseppe
Departamento de Saúde Coletiva, Centro de Ciências da Saúde, Universidade Federal do Rio Grande do Norte, Natal, RN, Brasil,
Departamento de Odontologia, Centro de Ciências da Saúde, UFRN.
Cien Saude Colet. 2015 Apr;20(4):1295-304. doi: 10.1590/1413-81232015204.09052014.
The scope of this study was to determine the prevalence of near misses and complications during pregnancy and the puerperal period, identifying the main clinical and intervention markers and socioeconomic and demographic factors associated with near misses. It involved a cross-sectional, population-based and probabilistic study with multi-stage complex sampling design conducted in Natal, State of Rio Grande do Norte, Brazil. A validated questionnaire was given to 848 women aged 15 to 49 identified in 8,227 households in 60 census sectors. In theanalysis of associations, the Chi-square test applied and calculated the prevalence ratio (PR) with Confidence Interval (CI) of 95% and 5% significance. The prevalence of maternal near misses was 41.1/1000LB, with hospitalization in an Intensive Care Unit (19.1/1000LB) and eclampsia (13.5/1000LB) being the most important markers. The prevalence of complications during pregnancy and the puerperal period was 21.2%. The highest prevalence of near misses was observed in older women, of black/brown race and low socioeconomic status. Conducting population surveys is feasible and may add important information to the study of near misses and the markers highlight the need for enhancing maternal care to reduce health inequality.
本研究的范围是确定妊娠期间及产褥期险些发生的孕产妇死亡和并发症的发生率，确定主要的临床和干预指标以及与险些发生的孕产妇死亡相关的社会经济和人口因素。这是一项在巴西北里奥格兰德州纳塔尔市进行的横断面、基于人群的概率研究，采用多阶段复杂抽样设计。向在60个普查区的8227户家庭中识别出的848名年龄在15至49岁之间的妇女发放了一份经过验证的问卷。在关联分析中，应用卡方检验并计算患病率比（PR），其95%置信区间（CI），显著性水平为5%。孕产妇险些发生的孕产妇死亡的发生率为41.1/1000活产，其中入住重症监护病房（19.1/1000活产）和子痫（13.5/1000活产）是最重要的指标。妊娠期间及产褥期并发症的发生率为21.2%。年龄较大、黑人/棕色人种和社会经济地位较低的妇女中险些发生的孕产妇死亡的发生率最高。开展人群调查是可行的，可能会为险些发生的孕产妇死亡研究增添重要信息，这些指标凸显了加强孕产妇护理以减少健康不平等的必要性。
