Contribution of antepartum and intrapartum hemorrhage to the burden of maternal near miss and death in a national surveillance study
- 11 November 2014
- journal article
- research article
- Published by Wiley in Acta Obstetricia et Gynecologica Scandinavica
- Vol. 94 (1), 50-58
- https://doi.org/10.1111/aogs.12529
Abstract
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.Multicenter cross-sectional study.Twenty-seven obstetric referral units in Brazil between July 2009 and June 2010.A total of 9555 women categorized as having obstetric complications.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.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.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).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.Keywords
Funding Information
- Brazilian CNPq (402702/2008-5)
This publication has 24 references indexed in Scilit:
- New approaches to obstetric hemorrhageCurrent Opinion in Anaesthesiology, 2014
- Blood Transfusion During Pregnancy, Birth, and the Postnatal PeriodObstetrics & Gynecology, 2014
- Authors' response to: Multiple repeat caesarean section in the UK: incidence and consequences to mother and child. A national, prospective cohort studyBJOG: An International Journal of Obstetrics and Gynaecology, 2013
- Reflections on the Maternal Mortality Millennium GoalBirth, 2013
- Incidence and Risk Factors for Placenta Accreta/Increta/Percreta in the UK: A National Case-Control StudyPLOS ONE, 2012
- The WHO Maternal Near-Miss Approach and the Maternal Severity Index Model (MSI): Tools for Assessing the Management of Severe Maternal MorbidityPLOS ONE, 2012
- The risk of preterm delivery prior to 34 weeks in women presenting with antepartum haemorrhage of unknown originAustralian and New Zealand Journal of Obstetrics and Gynaecology, 2012
- Impact of multiple cesarean deliveries on maternal morbidity: a systematic reviewAmerican Journal of Obstetrics and Gynecology, 2011
- Maternal near miss – towards a standard tool for monitoring quality of maternal health careBest Practice & Research Clinical Obstetrics & Gynaecology, 2009
- Major Obstetric HemorrhageAnesthesiology Clinics, 2008