TY - JOUR
T1 - Great saves or near misses? Severe maternal outcome in Metro East, South Africa
T2 - A region-wide population-based case-control study
AU - Heitkamp, Anke
AU - Vollmer, Linda
AU - van den Akker, Thomas
AU - Gebhardt, Gabriel S.
AU - Sandberg, Evelien M.
AU - van Roosmalen, Jos
AU - ter Wee, Marieke M.
AU - de Vries, Johanna I.
AU - Theron, Gerhard
N1 - Publisher Copyright: © 2021 The Authors. International Journal of Gynecology & Obstetrics published by John Wiley & Sons Ltd on behalf of International Federation of Gynecology and Obstetrics Copyright: Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2022/4
Y1 - 2022/4
N2 - Objective: To assess the incidence of severe maternal outcome (SMO), comprising maternal mortality (MM) and maternal near miss (MNM), in Metro East health district, Western Cape Province, South Africa between November 2014 and November 2015 and to identify associated determinants leading to SMO with the aim to improve maternity care. Methods: Region-wide population-based case-control study. Women were included in the study, if they were maternal deaths or met MNM criteria, both as defined by WHO. Characteristics of women with SMO were compared with those of a sample of women without SMO, matched for age and parity, taken from midwifery-led obstetrical units from two residential areas in Metro East, using multivariate regression analysis. Results: Incidence of SMO was 9.1 per 1000 live births, and incidence of MNM was 8.6 per 1000 live births. Main causes of SMO were obstetrical hemorrhage and hypertensive disorders. Factors associated with SMO were HIV (adjusted odds ratio [aOR] 24.8; 95% confidence interval [CI] 10.0–61.6), pre-eclampsia (aOR 17.5; 95% CI 7.9–38.7), birth by cesarean section (aOR 8.4; 95% CI 5.8–12.3), and chronic hypertension (aOR 2.4; 95% CI 1.1–5.1). Conclusion: Evaluation of SMO incidence and associated determinants supports optimizing tailored guidelines in Metro-East health district to improve maternal health.
AB - Objective: To assess the incidence of severe maternal outcome (SMO), comprising maternal mortality (MM) and maternal near miss (MNM), in Metro East health district, Western Cape Province, South Africa between November 2014 and November 2015 and to identify associated determinants leading to SMO with the aim to improve maternity care. Methods: Region-wide population-based case-control study. Women were included in the study, if they were maternal deaths or met MNM criteria, both as defined by WHO. Characteristics of women with SMO were compared with those of a sample of women without SMO, matched for age and parity, taken from midwifery-led obstetrical units from two residential areas in Metro East, using multivariate regression analysis. Results: Incidence of SMO was 9.1 per 1000 live births, and incidence of MNM was 8.6 per 1000 live births. Main causes of SMO were obstetrical hemorrhage and hypertensive disorders. Factors associated with SMO were HIV (adjusted odds ratio [aOR] 24.8; 95% confidence interval [CI] 10.0–61.6), pre-eclampsia (aOR 17.5; 95% CI 7.9–38.7), birth by cesarean section (aOR 8.4; 95% CI 5.8–12.3), and chronic hypertension (aOR 2.4; 95% CI 1.1–5.1). Conclusion: Evaluation of SMO incidence and associated determinants supports optimizing tailored guidelines in Metro-East health district to improve maternal health.
KW - South Africa
KW - case control
KW - maternal morbidity
KW - maternal mortality
KW - maternal near miss
KW - population-based
KW - severe maternal outcome
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U2 - https://doi.org/10.1002/ijgo.13739
DO - https://doi.org/10.1002/ijgo.13739
M3 - Article
C2 - 33977537
SN - 0020-7292
VL - 157
SP - 173
EP - 180
JO - International Journal of Gynecology and Obstetrics
JF - International Journal of Gynecology and Obstetrics
IS - 1
ER -
