Department of Nursing, Bahir Dar University, Bahir Dar, Ethiopia
Department of Epidemiology and Biostatistics, Bahir Dar University, Bahir Dar, Ethiopia.
BMJ Open. 2023 Nov 14;13(11):e074215. doi: 10.1136/bmjopen-2023-074215.
Maternal near-miss is a condition when a woman nearly died but survived from complications that happened during pregnancy, childbirth or within 42 days after delivery. Maternal near-miss is more prevalent among women in developing nations. Previous studies have identified the impact of different predictor variables on maternal near-miss but shared prognostic predictors are not adequately explored in Ethiopia. It is therefore necessary to build a clinical prediction model for maternal near-misses in Ethiopia. Hence, the aim of this study is to develop and validate a prognostic prediction model, and generate a risk score for maternal near-miss among pregnant women in Bahir Dar City Administration.
A prospective follow-up study design will be employed among 2110 selected pregnant women in the Bahir Dar City administration from 1 May 2023 to 1 April 2024. At the initial antenatal visit, pregnant women will be systematically selected. Then, they will be followed until 42 days following birth. Data will be collected using structured questionnaires and data extraction sheet. The model will be created using Cox proportional hazard regression analysis. The performance of the model will be assessed based on its capacity for discrimination using c-index and calibration using calibration plot, intercept and slope. The model's internal validity will be evaluated through the bootstrapping method. Ultimately, the model will be illustrated through a nomogram and decision tree, which will be made available to prospective users.
Ethical approval has been obtained from the Institutional Review Board of the College of Medicine and Health Sciences, Bahir Dar University (protocol number 704/2023). Findings will be published in peer-reviewed journals and local and international seminars, conferences, symposiums and workshops. Manuscripts will be prepared and published in scientifically reputable journals. In addition, policy briefs will be prepared.
孕产妇near-miss 是指一名女性在妊娠、分娩或产后 42 天内因并发症险些死亡但幸存的情况。孕产妇 near-miss 在发展中国家的女性中更为常见。先前的研究已经确定了不同预测变量对孕产妇 near-miss 的影响,但在埃塞俄比亚,尚未充分探讨共享的预后预测因素。因此,有必要在埃塞俄比亚建立孕产妇 near-miss 的临床预测模型。因此,本研究的目的是开发和验证一个预后预测模型,并为巴塞尔达市行政区域的孕妇建立孕产妇 near-miss 风险评分。
将采用前瞻性随访研究设计,在 2023 年 5 月 1 日至 2024 年 4 月 1 日期间在巴塞尔达市行政区域内选择 2110 名选定的孕妇。在最初的产前检查时,将系统地选择孕妇。然后,将对她们进行跟踪,直到产后 42 天。将使用结构化问卷和数据提取表收集数据。将使用 Cox 比例风险回归分析创建模型。将根据 c 指数评估模型的区分能力,使用校准图、截距和斜率评估校准能力,从而评估模型的性能。将通过 bootstrap 方法评估模型的内部有效性。最终,将通过列线图和决策树来展示模型,这些模型将提供给未来的用户。
巴塞尔达大学医学院和健康科学学院机构审查委员会已批准这项研究(编号 704/2023)。研究结果将发表在同行评议的期刊上,并在当地和国际研讨会、会议、专题讨论会和讲习班上进行介绍。将准备并在科学上有声誉的期刊上发表手稿。此外,还将编写政策简报。