Kamuzu College of Nursing, Kamuzu College of Nursing, University of Malawi and The Kamuzu University of Health Sciences.
Malawi University of Science and Technology, Malawi.
Malawi Med J. 2021 Apr;33(Postgraduate Supplementary Iss):3-9. doi: 10.4314/mmj.v33iS.2.
Maternal near-miss cases occur in larger numbers than maternal deaths hence they require comprehensive analysis when studied. However, there is scarcity of information on determinants of maternal near-miss cases in Malawi. Therefore, this study aimed at establishing the determinants of maternal near-miss cases at two selected central hospitals in Malawi.
This was a case control study that utilized a quantitative approach. A random sample of 458 case files comprising maternal near-miss cases (161) and non-cases (297) was drawn using a ratio of 1:1.8. Data were analyzed using Stata 14 to generate descriptive statistics, Chi Square values to describe the data and determine associations among variables and logistic regression was conducted to determine the determinants of maternal near-miss.
We found significant differences between demographic characteristics (marital status, occupation, admission mode, means of transport and age) of maternal near-miss cases and the non-cases (P<0.05). Age and mode of birth were found to be significantly associated (P<0. 05) with maternal near-miss. Women aged 31-35 years were 3.14 times more likely to experience maternal near-miss [OR=3.14, 95% CI: 1.09, 9.02, p=0.03] compared to those aged less than 20 years. Furthermore, emergency caesarean [OR=4.08, 95% CI: 2.34, 7.09, p=0.001] and laparotomy for uterine rupture [OR=83.49, 95% CI: 10.49, 664.55, P=0.001] were significantly associated with maternal near-miss.
Among pregnant women, health workers need to pay close attention to factors such as age and mode of birth for them to implement targeted maternal health services in order to reduce incidence of maternal near-miss cases.
产妇near-miss 病例的数量多于产妇死亡人数，因此在研究时需要进行全面分析。然而，马拉维关于产妇near-miss 病例决定因素的信息稀缺。因此，本研究旨在确定马拉维两家选定的中央医院的产妇near-miss 病例的决定因素。
这是一项病例对照研究，采用定量方法。使用 1:1.8 的比例，从包括产妇 near-miss 病例（161 例）和非病例（297 例）的 458 例病例文件中随机抽取了一个随机样本。使用 Stata 14 进行数据分析，生成描述性统计数据，使用卡方值描述数据，并确定变量之间的关联，以及进行逻辑回归以确定产妇 near-miss 的决定因素。
我们发现产妇 near-miss 病例和非病例在人口统计学特征（婚姻状况、职业、入院方式、交通方式和年龄）方面存在显著差异（P<0.05）。年龄和分娩方式与产妇 near-miss 显著相关（P<0.05）。年龄在 31-35 岁的女性发生产妇 near-miss 的可能性是年龄小于 20 岁的女性的 3.14 倍[OR=3.14，95%CI：1.09，9.02，p=0.03]。此外，急诊剖宫产[OR=4.08，95%CI：2.34，7.09，p=0.001]和子宫破裂剖腹术[OR=83.49，95%CI：10.49，664.55，P=0.001]与产妇 near-miss 显著相关。
在孕妇中，卫生工作者需要密切关注年龄和分娩方式等因素，以便实施有针对性的孕产妇保健服务，从而降低产妇 near-miss 病例的发生率。
