Asaye Mengstu Melkamu
Women and Family Health Department, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, P.O. Box 196, Ethiopia.
Int J Reprod Med. 2020 Mar 18;2020:5257431. doi: 10.1155/2020/5257431. eCollection 2020.
Life-threatening situations might arise unexpectedly during pregnancy. Maternal near-miss can be a proxy for maternal death and explained as women who nearly died due to obstetric-related complications. It is recognized as the predictor of level of care and maternal death. Maternal near-miss evaluates life-threatening pregnancy-related complications, and it directs the assessment of the quality of obstetric care.
To determine the proportion and factors associated with maternal near-miss at maternity wards at the University of Gondar Referral Hospital, Northwest Ethiopia, 2019.
A cross-sectional study design was carried out from March 1 to June 20, 2019, using WHO criteria for maternal near-miss at the University of Gondar Referral Hospital. The data are from the interviews and review of 303 systematically selected participants' medical files at maternity wards. Bivariate and multivariable logistic regression analyses were performed to analyze factors associated with maternal near-miss, including estimation of crude and adjusted odds ratios and their respective 95% confidence intervals and value less than 0.05 through SPSS version 20.
The study revealed that the proportion of maternal near-miss was found to be 15.8% (95%CI = 11.9%-20.1%). In the adjusted analyses, maternal near-miss was significantly associated with low (≤1000 ETB) monthly income (AOR = 399; 95%CI = 1.65, 9.65), seven or more days of hospital stay (AOR = 5.43; 95%CI = 2.49, 11.83), vaginal bleeding (AOR = 2.75, 95%CI = 1.17, 6.47), and pregnancy-induced hypertension (AOR = 5.13; 95%CI = 2.08, 12.6). . The near-miss proportion was comparable to that in the region. Associated factors were low monthly income, seven or more days of hospital stay, vaginal bleeding, and pregnancy-induced hypertension. Thus, giving attention on early identification and treatment of these potential factors can be the opportunity in the reduction of maternal morbidity and mortality.
孕期可能会意外出现危及生命的情况。孕产妇险些死亡可作为孕产妇死亡的一个替代指标，定义为因产科相关并发症而险些死亡的女性。它被认为是护理水平和孕产妇死亡的预测指标。孕产妇险些死亡评估危及生命的妊娠相关并发症，并指导对产科护理质量的评估。
确定2019年埃塞俄比亚西北部贡德尔大学转诊医院产科病房孕产妇险些死亡的比例及相关因素。
2019年3月1日至6月20日采用横断面研究设计，在贡德尔大学转诊医院使用世界卫生组织的孕产妇险些死亡标准。数据来自对产科病房303名系统选取的参与者的医疗档案进行的访谈和审查。采用双变量和多变量逻辑回归分析来分析与孕产妇险些死亡相关的因素，包括估计粗比值比和调整后的比值比及其各自的95%置信区间，并通过SPSS 20版得出P值小于0.05。
研究显示，孕产妇险些死亡的比例为15.8%（95%置信区间=11.9%-20.1%）。在调整分析中，孕产妇险些死亡与低月收入（≤1000埃塞俄比亚比尔）（调整后比值比=3.99；95%置信区间=1.65，9.65）、住院7天或更长时间（调整后比值比=5.43；95%置信区间=2.49，11.83）、阴道出血（调整后比值比=2.75，95%置信区间=1.17，6.47）和妊娠高血压（调整后比值比=5.13；95%置信区间=2.08，12.6）显著相关。险些死亡比例与该地区相当。相关因素为低月收入、住院7天或更长时间、阴道出血和妊娠高血压。因此，关注这些潜在因素的早期识别和治疗可能是降低孕产妇发病率和死亡率的契机。
