Magalhães Daniela Mendes Dos Santos, Bernardes João Marcos, Ruiz-Frutos Carlos, Gómez-Salgado Juan, Calderon Iracema de Mattos Paranhos, Dias Adriano
Gynecology, Obstetrics and Mastology Posgraduate Programme, Botucatu Medical School, São Paulo State University (UNESP), Botucatu, Sao Paulo 18618-687, Brazil.
Secretary of State for Health of the Federal District, Brasilia 70390-150, Brazil.
Healthcare (Basel). 2021 Mar 16;9(3):335. doi: 10.3390/healthcare9030335.
The maternal mortality or "maternal near miss" ratio in Brazil reflects the socioeconomic indicators as well as the healthcare quality in some areas of this country, pointing out fragile points in the health services. The aim of this study was to estimate the association of diverse variables related to pregnancy and the occurrence of Near Miss in a population of women who were cared in public maternity wards in Brazil. A case-control study was performed. The association between variables and outcomes was verified through a chi-square test. A multiple analysis was carried out, producing odds ratio (OR) estimates with values of ≤0.25 in the univariate model. The results point to the following risk factors for Severe Maternal Morbidity: non-white (<0.001, OR 2.973), family income of up to two minimum wage salaries (<0.001; OR 2.159), not having a partner (<0.001, OR 2.694), obesity (<0.001, OR 20.852), not having received pre-natal care (<0.001, OR 2.843), going to less than six prenatal appointments (<0.001, OR 3.498), undergoing an inter-hospital transfer (<0.001, OR 24.655), and the absence of labor during admission (<0.001, OR 25.205). Although the results vary, the incidence of women with potential life-threatening complications is high in Brazil, which reinforces the need to universalize more complex interventions as well as coverage of primary care. The presence of precarious socio-economic indicators and unqualified obstetric care were risk factors for Severe Maternal Morbidity.
巴西的孕产妇死亡率或“孕产妇接近死亡”比率反映了该国某些地区的社会经济指标以及医疗质量，指出了卫生服务中的薄弱环节。本研究的目的是估计与妊娠相关的各种变量与在巴西公立产科病房接受护理的女性群体中发生接近死亡情况之间的关联。进行了一项病例对照研究。通过卡方检验验证变量与结果之间的关联。进行了多因素分析，在单变量模型中得出比值比（OR）估计值≤0.25。结果表明严重孕产妇发病的以下风险因素：非白人（<0.001，OR 2.973）、家庭收入至多为两个最低工资（<0.001；OR 2.159）、没有伴侣（<0.001，OR 2.694）、肥胖（<0.001，OR 20.852）、未接受产前护理（<0.001，OR 2.843）、产前检查次数少于六次（<0.001，OR 3.498）、进行院际转诊（<0.001，OR 24.655）以及入院时未临产（<0.001，OR 25.205）。尽管结果有所不同，但巴西潜在危及生命并发症的女性发病率很高，这强化了普及更复杂干预措施以及初级保健覆盖范围必要性。不稳定的社会经济指标和不合格的产科护理是严重孕产妇发病的风险因素。
