Severe maternal morbidity and maternal near miss in the extremes of reproductive age: results from a national cross- sectional multicenter study

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• 作者：Fernando César Oliveira Jr (1) (2)
  Fernanda Garanhani Surita (1)
  Jo?o Luiz Pinto e Silva (1)
  José Guilherme Cecatti (1)
  Mary Angela Parpinelli (1)
  Samira M Haddad (1)
  Maria Laura Costa (1)
  Rodolfo Carvalho Pacagnella (1)
  Maria Helena Sousa (3)
  Jo?o Paulo Souza (3)
  
• 关键词：Maternal near ; miss ; Obstetric complication ; Maternal death ; Maternal age ; Extremes of reproductive age ; Maternal morbidity
• 刊名：BMC Pregnancy and Childbirth
• 出版年：2014
• 出版时间：December 2014
• 年：2014
• 卷：14
• 期：1
• 全文大小：193 KB
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• 作者单位：Fernando César Oliveira Jr (1) (2)
  Fernanda Garanhani Surita (1)
  Jo?o Luiz Pinto e Silva (1)
  José Guilherme Cecatti (1)
  Mary Angela Parpinelli (1)
  Samira M Haddad (1)
  Maria Laura Costa (1)
  Rodolfo Carvalho Pacagnella (1)
  Maria Helena Sousa (3)
  Jo?o Paulo Souza (3)
  
  1. Department of Obstetrics and Gynecology, University of Campinas, Rua Alexander Fleming, 101, 13083-881, Campinas, SP, Brazil
  2. Department of Gynecology and Obstetrics, Federal University of Paraná, Curitiba, PR, Brazil
  3. Cemicamp: Centre for Research on Reproductive Health of Campinas, Campinas, Brazil
  
• ISSN：1471-2393

文摘

Background The aim of this study was to assess severe maternal morbidity (SMM) and near miss (NM) cases among adolescent girls and women over 35?years of age in the Brazilian Network for Surveillance of Severe Maternal Morbidity, using a set of standard criteria, compared to pregnant women aged 20 to 34?years. Methods A cross-sectional multicenter study conducted in 27 referral obstetric units in Brazil. All pregnant women admitted to these centers during a one-year period of prospective surveillance were screened to identify cases of maternal death (MD), NM and other SMM. Indicators of maternal morbidity and mortality were evaluated for the three age groups. Sociodemographic, clinical and obstetric characteristics, gestational and perinatal outcomes, main causes of morbidity and delays in care were also compared. Two multiple analysis models were performed, to estimate the adjusted prevalence ratio for identified factors that were independently associated with the occurrence of severe maternal outcome (SMO-?MNM-?MD). Results Among SMM and MD cases identified, the proportion of adolescent girls and older women were 17% each. The risk of MNM or death was 25% higher among older women. Maternal near miss ratio and maternal mortality ratios increased with age, but these ratios were also higher among adolescents aged 10 to 14, although the absolute numbers were low. On multivariate analysis, younger age was not identified as an independent risk factor for SMO, while this was true for older age (PR 1.25; 1.07-1.45). Conclusions SMO was high among women below 14?years of age and increased with age in Brazilian pregnant women.