Abdollahpour Sedigheh, Miri Hamid Heidarian, Azmoude Elham, Pieranj Mahsa, Kabirian Maryam
Ph.D. in Reproductive Health, School of Nursing and Midwifery, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran.
Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
Iran J Nurs Midwifery Res. 2023 Jun 21;28(3):244-249. doi: 10.4103/ijnmr.ijnmr_168_21. eCollection 2023 May-Jun.
The investigation of Maternal Near-Miss (MNM) risk factors is important for the global reduction of maternal mortality. This study aimed to identify the determinants of MNM among pregnant women in northeastern Iran.
A prospective case-control study was conducted on 250 women referred to the maternity ward of Nohom-e-Dey hospital in Torbat-e Heydarieh, Iran, from June 2018 to May 2020. Applying the criteria of the World Health Organization tool, near-miss mothers were taken as cases, and mothers with normal obstetric outcomes were selected as controls with convenience sampling. Logistic regression models using Stata version 14.0 and odds ratios (95% confidence intervals) were reported.
A total of 123 MNM cases and 127 controls were included in the study. The multiple logistic regression represented that having had previous abortion, living in rural or urban areas, whether the mother went through C/S or vaginal delivery and level of prenatal education were associated with MNM. Besides, having experienced chronic medical diseases during pregnancy had the strongest association with MNM, and next were complications during childbirth and neonatal outcomes which were associated with MNM, although in terms of statistical association, only the first two mentioned factors were statistically significant.
Determinants of MNM could be experiencing chronic medical disorders during maternal complications. Health providers need to carefully manage past medical history and adverse perinatal outcomes, especially in pregnant women who live in rural areas. Encouraging mothers to attend pregnancy training classes is effective in reducing MNM.
孕产妇接近死亡（MNM）风险因素的调查对于全球降低孕产妇死亡率至关重要。本研究旨在确定伊朗东北部孕妇中MNM的决定因素。
2018年6月至2020年5月，对转诊至伊朗托尔巴特-海达里耶市诺霍姆-德伊医院产科病房的250名妇女进行了一项前瞻性病例对照研究。采用世界卫生组织工具的标准，将接近死亡的母亲作为病例，将产科结局正常的母亲作为对照，采用方便抽样法进行选择。报告了使用Stata 14.0版本的逻辑回归模型和比值比（95%置信区间）。
本研究共纳入123例MNM病例和127例对照。多元逻辑回归表明，既往有流产史、居住在农村或城市地区、母亲是剖宫产还是阴道分娩以及产前教育水平与MNM有关。此外，孕期患有慢性疾病与MNM的关联最强，其次是分娩期间的并发症和与MNM相关的新生儿结局，尽管就统计关联而言，只有上述前两个因素具有统计学意义。
MNM的决定因素可能是孕产妇并发症期间患有慢性疾病。卫生保健人员需要仔细管理既往病史和不良围产期结局，尤其是在农村地区的孕妇中。鼓励母亲参加孕期培训班对降低MNM有效。
