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

Grant number: 14/03200-3
Support type:Regular Research Grants - Publications - Scientific article
Duration: April 01, 2014 - September 30, 2014
Field of knowledge:Health Sciences - Medicine - Maternal and Child Health
Principal Investigator:Fernanda Garanhani de Castro Surita
Grantee:Fernanda Garanhani de Castro Surita
Home Institution: Faculdade de Ciências Médicas (FCM). Universidade Estadual de Campinas (UNICAMP). Campinas , SP, Brazil

Abstract

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. (AU)

Scientific publications
(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)
OLIVEIRA, JR., FERNANDO CESAR; SURITA, FERNANDA GARANHANI; PINTO E SILVA, JOAO LUIZ; CECATTI, JOSE GUILHERME; PARPINELLI, MARY ANGELA; HADDAD, SAMIRA M.; COSTA, MARIA LAURA; PACAGNELLA, RODOLFO CARVALHO; SOUSA, MARIA HELENA; SOUZA, JOAO PAULO; SEV, BRAZILIAN NETWORK SURVEILLANCE. Severe maternal morbidity and maternal near miss in the extremes of reproductive age: results from a national cross- sectional multicenter study. BMC PREGNANCY AND CHILDBIRTH, v. 14, FEB 20 2014. Web of Science Citations: 18.

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