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Background The prevalence of (pre-)eclampsia in pregnant women in Haiti is high and access to maternal health services is scarce. Limited evidence exists around negative maternal and neonatal outcomes in Haitian women and their offspring. We describe the patient profile of women admitted to an obstetric emergency hospital in Port-au-Prince between January 2013 and June 2018 and the estimated risk factors for maternal death, stillbirth and low birthweight (LBW). Methods We calculated frequencies of age groups, singleton vs. multiple pregnancies, delivery procedures and antenatal care (ANC) services for all maternal admissions. We estimated the associated risk between these factors and the three negative outcomes by calculating odds ratios (OR) and their 95% confidence intervals (CI) using univariate and multivariate logistic regression. We adjusted for an interaction between delivery procedure and pregnancy category in the regression models for maternal death and stillbirth. Results We included 31,509 women and 24,983 deliveries and documented 204 (0.6%) maternal deaths (648/100,000 women giving birth), 1,962 (7.9%) stillbirths and 11,008 (44.1%) LBW neonates. 34.9% of all admissions (n = 10,991) were women with (pre-)eclampsia. Maternal death was more likely in women with complicated pregnancies and/or deliveries and women with (pre-)eclampsia when undergoing a C-section compared to women with uncomplicated vaginal deliveries (OR 4.8; CI 1.7–13.8 and OR 2.3; CI 1.5–3.6 respectively). Stillbirth was more likely in women ≥ 35 years compared to women 20–34 years in complicated pregnancies and/or deliveries (OR 1.3; CI 1.1–1.6) and (pre-)eclampsia (OR 1.4; CI 1.2–1.7). C-sections in women with a complicated pregnancy and/or delivery and women with (pre-)eclampsia reduced the risk of stillbirth (OR 0.7; CI 0.6–0.9 and OR 0.3; CI 0.2–0.3 respectively). Not attending ANC was associated with a higher risk of stillbirth (OR 4.8; CI 3.6–6.6) and LBW (OR 1.4; CI 1.1–1.9) for women with complicated pregnancies and/or deliveries. Conclusion Maternal mortality in high-risk pregnancies in CRUO is higher than the national estimate of 529 per 100,000 deliveries. Attendance of ANC services is associated with a decrease in adverse neonatal outcomes including LBW and stillbirth. We recommend that access to maternal and neonatal healthcare facilities in Port-au-Prince is improved.

To determine the prevalence of maternal death, stillbirth and low birthweight in women with (pre-)eclampsia and complicated pregnancies or deliveries in Centre de Références des Urgences Obstétricales, an obstetric emergency hospital in Port-au-Prince, Haiti, and to identify the main risk factors for these adverse pregnancy outcomes.We conducted a retrospective cohort study of pregnant women admitted to Centre de Référence des Urgences Obstétricales between 2013 and 2018 using hospital records. Risk factors investigated were age group, type of pregnancy (singleton, multiple), type of delivery and use of antenatal care services.A total of 31 509 women and 24 983 deliveries were included in the analysis. Among these, 204 (0.6%) maternal deaths (648 per 100 000 women giving birth), 1962 (7.9%) stillbirths and 11 008 (44.1%) low birthweight neonates were identified. Of all admissions, 10 991 (34.9%) were women with (pre-)eclampsia. Caesarean section significantly increased the risk of maternal death in the women with a complicated pregnancy and women with (pre-)eclampsia, but reduced the risk of stillbirth in such women. Not attending antenatal care was associated with a significantly higher risk of stillbirth (odds ratio (OR) 4.82; 95% confidence interval (CI) 3.55-6.55) and low birthweight (OR 1.40; 95% CI 1.05-1.86) for women with complicated pregnancies.To prevent and treat pregnancy complications as early as possible, antenatal care attendance is crucial. Improving the quality of and access to antenatal care services and providing it free to all pregnant women in Haiti is recommended.Determinar la prevalencia de la muerte materna, la mortinatalidad y el peso bajo al nacer en mujeres con eclampsia o preeclampsia y embarazos o partos complicados en el Centre de Références des Urgences Obstétricales, un hospital de urgencia obstétrica en Puerto Príncipe (Haití), e identificar los principales factores de riesgo de estos resultados adversos del embarazo.Se llevó a cabo un estudio de cohortes retrospectivo con embarazadas ingresadas en el Centre de Références des Urgences Obstétricales entre el año 2013 y el 2018 empleando los registros del hospital. Se investigaron como factores de riesgo el grupo etario, el tipo de embarazo (único o múltiple), el tipo de parto y el uso de los servicios de atención prenatal.Se incluyó en el análisis un total de 31 509 mujeres y 24 983 partos. De estos, se documentaron 204 (0,6 %) muertes maternas (648 de cada 100 000 mujeres que dan a luz), 1962 (7,9 %) mortinatos y 11 008 (44,1%) recién nacidos con peso bajo al nacer. De todos los ingresos, 10 991 (34,9 %) fueron mujeres con eclampsia y preeclampsia. La cesárea aumentó significativamente el riesgo de muerte materna en mujeres con un embarazo complicado y mujeres con eclampsia y preeclampsia, si bien redujo el riesgo de mortinatalidad en estas mujeres. No asistir a la atención prenatal se asoció con un riesgo significativamente mayor de mortinatalidad (razón de posibilidades [OR] 4,82; intervalo de confianza [IC] de 95 % 3,55-6,55) y peso bajo al nacer (OR 1,40; IC de 95 % 1,05-1,86) en mujeres con embarazos complicados.Para prevenir y tratar las complicaciones del embarazo lo antes posible, es crucial asistir a la atención prenatal. Se recomienda mejorar el acceso a servicios de atención prenatal de buena calidad y ofrecerlos de manera gratuita a todas las embarazadas en Haití.Determinar a prevalência de mortalidade materna, natimortos e baixo peso ao nascer em mulheres em pré-eclâmpsia, ou gravidez ou partos com complicações noRealizamos um estudo de coorte retrospectivo de gestantes admitidas noA análise incluiu um total de 31.509 mulheres e 24.983 partos. Entre eles, 204 (0,6%) mortes maternas (648 por 100.000 mulheres que deram à luz), 1.962 (7,9%) natimortos e 11.008 (44,1%) recém-nascidos com baixo peso ao nascer estavam documentados. De todas as internações, 10.991 (34,9%) eram de mulheres em pré-eclâmpsia. Parto cesariana aumentou significativamente o risco de mortalidade materna nas mulheres com complicações na gravidez e com pré-eclâmpsia, mas reduziu o risco de natimorto nessas mulheres. Não fazer acompanhamento pré-natal foi associado a risco significativamente maior de natimorto (razão de chances (OR) 4,82; intervalo de confiança de 95% (IC) 3,55-6,55) e baixo peso ao nascer (OR 1,40; IC de 95% 1,05-1,86) para as mulheres com complicações na gravidez.Para prevenir e tratar as complicações da gravidez o mais precocemente possível, o acompanhamento pré-natal é crucial. Recomenda-se o aprimoramento do acesso a serviços de atendimento pré-natal de qualidade e oferecidos gratuitamente a todas as gestantes do Haiti.

Collaboration between the Haitian government and NGOs after the 2010 earthquake contributed to a more accurate and complete master health facility list, which helped coordinate emergency response operations as well as strengthen the routine health information system. Open data and social networks facilitated the collection and sharing of health facility information and in maintenance of the list over time., Master health facility lists (MHFLs) are gaining attention as a standards-based means to uniquely identify health facilities and to link facility-level data. The ability to reliably communicate information about specific health facilities can support an array of health system functions, such as routine reporting and emergency response operations. MHFLs support the alignment of donor-supported health information systems with county-owned systems. Recent World Health Organization draft guidance promotes the utility of MHFLs and outlines a process for list development and governance. Although the potential benefits of MHFLs are numerous and may seem obvious, there are few documented cases of MHFL construction and use. The international response to the 2010 Haiti earthquake provides an example of how governments, nongovernmental organizations, and others can collaborate within a framework of standards to build a more complete and accurate list of health facilities. Prior to the earthquake, the Haitian Ministry of Health (Ministère de la Santé Publique et de la Population [MSPP]) maintained a list of public-sector health facilities but lacked information on privately managed facilities. Following the earthquake, the MSPP worked with a multinational group to expand the completeness and accuracy of the list of health facilities, including information on post-quake operational status. This list later proved useful in the response to the cholera epidemic and is now incorporated into the MSPP's routine health information system. Haiti's experience demonstrates the utility of MHFL formation and use in crisis as well as in the routine function of the health information system.

After Hurricane Jeanne in September 2004, surveillance for mosquitoborne diseases in Gonaives, Haiti, identified 3 patients with malaria, 2 with acute dengue infections, and 2 with acute West Nile virus infections among 116 febrile patients. These are the first reported human West Nile virus infections on the island of Hispaniola.