1. Contribution of antepartum and intrapartum hemorrhage to the burden of maternal near miss and death in a national surveillance study.
- Author
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Rocha Filho EA, Costa ML, Cecatti JG, Parpinelli MA, Haddad SM, Sousa MH, Melo EF Jr, Surita FG, and Souza JP
- Subjects
- Adolescent, Adult, Brazil, Confidence Intervals, Cross-Sectional Studies, Delivery, Obstetric adverse effects, Delivery, Obstetric methods, Female, Hospitals, Maternity, Humans, Logistic Models, Maternal Mortality, Middle Aged, Multivariate Analysis, Obstetric Labor Complications economics, Pregnancy, Pregnancy Complications diagnosis, Prenatal Care, Risk Assessment, Severity of Illness Index, Socioeconomic Factors, Uterine Hemorrhage diagnosis, Uterine Hemorrhage economics, Young Adult, Cause of Death, Cost of Illness, Obstetric Labor Complications mortality, Pregnancy Complications epidemiology, Uterine Hemorrhage mortality
- Abstract
Objective: To evaluate the occurrence of severe obstetric complications associated with antepartum and intrapartum hemorrhage among women from the Brazilian Network for Surveillance of Severe Maternal Morbidity., Design: Multicenter cross-sectional study., Setting: Twenty-seven obstetric referral units in Brazil between July 2009 and June 2010., Population: A total of 9555 women categorized as having obstetric complications., Methods: The occurrence of potentially life-threatening conditions, maternal near miss and maternal deaths associated with antepartum and intrapartum hemorrhage was evaluated. Sociodemographic and obstetric characteristics and the use of criteria for management of severe bleeding were also assessed in these women., Main Outcome Measures: The prevalence ratios with their respective 95% confidence intervals adjusted for the cluster effect of the design, and multiple logistic regression analysis were performed to identify factors independently associated with the occurrence of severe maternal outcome., Results: Antepartum and intrapartum hemorrhage occurred in only 8% (767) of women experiencing any type of obstetric complication. However, it was responsible for 18.2% (140) of maternal near miss and 10% (14) of maternal death cases. On multivariate analysis, maternal age and previous cesarean section were shown to be independently associated with an increased risk of severe maternal outcome (near miss or death)., Conclusion: Severe maternal outcome due to antepartum and intrapartum hemorrhage was highly prevalent among Brazilian women. Certain risk factors, maternal age and previous cesarean delivery in particular, were associated with the occurrence of bleeding., (© 2014 Nordic Federation of Societies of Obstetrics and Gynecology.)
- Published
- 2015
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