Yemane Yayehyirad, Tiruneh Firew
Department of Midwifery, College of Health Sciences, Mizan-Tepi University, Mizan Teferi, Ethiopia.
Int J Womens Health. 2020 Dec 3;12:1125-1134. doi: 10.2147/IJWH.S283122. eCollection 2020.
Pregnancy-related morbidity and mortality continue to have a serious impact on the lives of women all over the world. Women in sub-Saharan Africa accounted for nearly two-thirds of global maternal deaths. The World Health Organization recommends monitoring maternal near-miss provides better information regarding the quality of maternal health care, on which to base action to prevent further death. Accordingly, this study sought to assess the incidence-proportion of maternal near-miss and its risk factors. We have also seen the near-miss-to-mortality ratio and overall maternal mortality index.
An institution-based prospective cross-sectional study was carried out from February 6, 2017 to March 6, 2017, using the WHO criteria for maternal near-misses at the three randomly selected public hospitals. About 845 participants were enrolled in the study with systematic random sampling techniques. WHO multi-country survey on maternal and neonatal health tool was used. Descriptive statistics and bivariate logistic regression analysis were done. Variables with p-value <0.2 in the bivariate analysis were transferred to multivariable analysis, and during multivariate logistic regression analysis, variables with P-value <0.05 were considered as statistically significant with 95% CI.
There were 5530 live births, 210 maternal near-misses, 17 maternal deaths, and 364 maternal near-miss events. The overall proportion of maternal near-miss is 24.85%. Besides, the ratio of maternal near-misses to maternal mortality was 12.35:1, and the overall mortality index was 7.48%. Parity, residence, a distance of maternal home from the hospital, ANC follow-up, duration of labor, and administration-related problems were found to have statistically significant associations.
The incidence-proportion of maternal near-misses is relatively high when compared against the national target and to other regional studies. Besides, with all its limitations, the outcome indicators and outcome measures in this study seem to suggest optimum care is being given to mothers who suffered from life-threatening complications.
与妊娠相关的发病和死亡继续对世界各地妇女的生活产生严重影响。撒哈拉以南非洲的妇女占全球孕产妇死亡人数的近三分之二。世界卫生组织建议监测孕产妇接近死亡情况，以提供有关孕产妇保健质量的更好信息，据此采取行动预防进一步死亡。因此，本研究旨在评估孕产妇接近死亡的发病率及危险因素。我们还计算了接近死亡与死亡的比率以及总体孕产妇死亡率指数。
2017年2月6日至2017年3月6日，在三家随机选择的公立医院，采用世界卫生组织孕产妇接近死亡的标准，开展了一项基于机构的前瞻性横断面研究。采用系统随机抽样技术，约845名参与者纳入本研究。使用了世界卫生组织多国孕产妇和新生儿健康调查工具。进行了描述性统计和双变量逻辑回归分析。双变量分析中P值<0.2的变量转入多变量分析，在多变量逻辑回归分析中，P值<0.05的变量被认为具有统计学意义，95%置信区间。
共有5530例活产，210例孕产妇接近死亡，17例孕产妇死亡，364例孕产妇接近死亡事件。孕产妇接近死亡的总体比例为24.85%。此外，孕产妇接近死亡与孕产妇死亡的比率为12.35:1，总体死亡率指数为7.48%。发现产次、居住地、产妇家与医院的距离、产前检查随访、产程持续时间以及管理相关问题具有统计学意义的关联。
与国家目标和其他区域研究相比，孕产妇接近死亡的发病率相对较高。此外，尽管本研究存在局限性，但其结果指标和结果测量似乎表明，对患有危及生命并发症的母亲给予了最佳护理。
