Factors associated with serious maternal morbidity in Ribeirão Preto, São Paulo State, Brazil: a cross-sectional cohort study

Author(s):Show less -

Magna Santos Andrade ^[1] ; Lívia Pimenta Bonifácio ^[2] ; Jazmin Andrea Cifuentes Sanchez ^[3] ; Lívia Oliveira-Ciabati ^[4] ; Fabiani Spessoto Zaratini ^[5] ; Ana Carolina Arruda Franzon ^[6] ; Vicky Nogueira Pileggi ^[7] ; Giordana Campos Braga ^[8] ; Mariana Fernandes ^[9] ; Carolina Sales Vieira ^[10] ; João Paulo Souza ^[11] ; Elisabeth Meloni Vieira ^[12]

Affiliation:Show less -

^[1] Universidade do Estado da Bahia - Brasil

^[2] Universidade de São Paulo - Brasil

^[3] Universidade de São Paulo - Brasil

^[4] Universidade de São Paulo - Brasil

^[5] Universidade de São Paulo - Brasil

^[6] Universidade de São Paulo - Brasil

^[7] Universidade de São Paulo - Brasil

^[8] Universidade de São Paulo - Brasil

^[9] Universidade de São Paulo - Brasil

^[10] Universidade de São Paulo - Brasil

^[11] Universidade de São Paulo - Brasil

^[12] Universidade de São Paulo - Brasil

• Document type: Journal article
• Source: Cadernos de Saúde Pública; v. 38, n. 1 2022-01-12.

Abstract

This study investigated the factors associated with serious maternal morbidity (SMM) in women seen at public maternity hospitals in Ribeirão Preto, São Paulo State, Brazil. This was a cross-section analytical quantitative study. Participation included 1,098 postpartum women who had given birth at one of the four maternity hospitals in the municipality. Data were collected from August 3, 2015, to February 2, 2016, using face-to-face interviews and data obtained from patient records and prenatal cards. The dependent variable for data analysis was the serious maternal morbidity, that is, when the woman was classified as maternal near miss or potentially life-threatening condition based on WHO eligibility criteria. The study calculated the maternal near miss ratio, odds ratio (OR), 95% confidence interval (95%CI), and multiple logistic regression. The maternal near miss ratio was 3.6 cases per 1,000 live births. Complications occurred mainly during pregnancy (53.8%), and hypertensive disorders were the most frequent (49.4%). Multiple regression analysis showed an association between serious maternal morbidity and high-risk pregnancy (OR = 4.5, 95%CI: 2.7-7.7) and induced labor (OR = 2.1, 95%CI: 1.2-3.9). The occurrence of serious maternal morbidity mainly during pregnancy, featuring hypertensive syndromes, points to the need for better screening and management of high blood pressure in the prenatal period. The association between serious maternal morbidity and high-risk pregnancy also calls attention to prenatal care, for the demand for greater care for women classified as having gestational risk. Quality of care is a key point for dealing with maternal morbidity and mortality in Brazil. (AU)

• FAPESP's process: 15/16932-5 - PRENACEL: Development and evaluation of a communication strategy to improve quality of prenatal care
• Grantee: Elisabeth Meloni Vieira
• Support Opportunities: Regular Research Grants