Danusa Kababa Temesgen, Debelo Bikila Tefera, Wakgari Negash, Seifu Benyam, Kenasa Ketema, Daba Gurmesa, Wondimu Fikadu, Berhanu Keneni
Department of Midwifery, College of Medicine and Health Sciences, Ambo University, Ambo, Ethiopia.
Front Med (Lausanne). 2022 Apr 29;9:868992. doi: 10.3389/fmed.2022.868992. eCollection 2022.
Maternal mortality reduction remains a priority to ensure healthy lives and promote wellbeing for mothers and newborns in the new sustainable development goals agenda. There is no evidence-based study done regarding maternal complications and near-miss in the study area.
This study assessed the predictors of maternal near-miss in public hospitals of West Shoa Zone, Central Ethiopia, 2020.
An unmatched case-control study was conducted among 664 (166 cases and 498 controls) women who gave birth in public institutions in the West Shewa zone. Structured questionnaires and checklists were used to collect the data. Bivariate, multivariable logistic regression, and adjusted odds ratios were used to describe the strength and directions of association.
The odds of maternal near-miss were higher among mothers with increased maternal age [Adjusted odds ratio (AOR) = 1.065, 95%CI: (1.015-1.117)], who could not read and write (AOR = 3.06, 95%CI: 1.314-7.135), had primary (AOR = 3.49, 95%CI: 1.518-8.044), and secondary (AOR = 3.213, 95%CI: 1.418-7.282), had no antenatal care (ANC) follow-up (AOR = 2.25, 95%CI: 1.100-4.607), mothers who had a first delay of more than 6 h [AOR = 2.38, 95%CI: (1.517-3.735)] and the distance from health facility of > 60 min [AOR = 4.021, 95%CI: (1.817-8.896)].
In this study, delay in decision making and reaching the health facility, lower educational status, not having ANC follow-up, and increased maternal age were significantly associated with maternal near misses. Therefore, the Ethiopian federal ministry of health and other stakeholders should work on increasing ANC coverage, awareness creation, and strong means of transportation to tackle the complications of a maternal near miss.
在新的可持续发展目标议程中，降低孕产妇死亡率仍然是确保母亲和新生儿健康生活及促进福祉的优先事项。在研究区域内，尚未开展关于孕产妇并发症和接近死亡情况的循证研究。
本研究评估了2020年埃塞俄比亚中部西绍阿地区公立医院中孕产妇接近死亡情况的预测因素。
在西绍阿地区公立机构分娩的664名妇女（166例病例和498名对照）中开展了一项非匹配病例对照研究。使用结构化问卷和检查表收集数据。采用双变量、多变量逻辑回归及调整后的比值比来描述关联的强度和方向。
孕产妇年龄增加的母亲发生孕产妇接近死亡情况的几率更高[调整后的比值比（AOR）=1.065，95%置信区间：（1.015 - 1.117）]，不识字的母亲（AOR = 3.06，95%置信区间：1.314 - 7.135），接受小学（AOR = 3.49，95%置信区间：1.518 - 8.044）和中学教育的母亲（AOR = 3.213，95%置信区间：1.418 - 7.282），未接受产前检查（ANC）随访的母亲（AOR =
2.25，95%置信区间：1.100 - 4.607），首次延迟超过6小时的母亲[AOR = 2.38，95%置信区间：（1.517 - 3.735）]以及距离医疗机构超过60分钟路程的母亲[AOR = 4.021, 95%置信区间：（1.817 - 8.896）]。
在本研究中，决策和前往医疗机构的延迟、较低的教育水平、未进行产前检查随访以及孕产妇年龄增加与孕产妇接近死亡情况显著相关。因此，埃塞俄比亚联邦卫生部和其他利益相关者应致力于提高产前检查覆盖率、提高认识并提供强有力的交通方式，以应对孕产妇接近死亡的并发症。
