Incidence of Adverse Perinatal Outcomes Among Women Exposed to Maternal Near-Misses in Arsi Zone in Ethiopia: Prospective Cohort Study in 2022

Overview

Journal J Pregnancy

Publisher Wiley

Specialty Gynecology & Obstetrics

Date 2024 Mar 29

PMID 38550878

Authors

Wogene Morka

Getu Megersa

Elias Bekele

Abdi Deksisa

Affiliations

Soon will be listed here.

Abstract

Background: Exposure to maternal near-misses has a massive effect on adverse perinatal outcomes. Hence, investigating the effect of maternal near-misses on perinatal outcomes can aid in the reduction of perinatal morbidity and mortality. The study is aimed at assessing the incidence of adverse perinatal outcomes among women exposed to maternal near-misses at Arsi Zone public hospitals in Ethiopia in 2022.

Method: The study included a prospective cohort of 335 women at Arsi Zone public hospitals from December 2021 to June 2022. Women who were admitted for management of pregnancy were followed. The exposed group was women with maternal near-misses screened based on disease-validated criteria. The nonexposed group was made up of women who delivered without complications. Trained data collectors used pretested, structured questionnaires to collect data from women. Pertinent data was also extracted from the clients' logbooks. Data was transferred from EpiData version 3.1 to SPSS version 25 for analysis, logistic regression was computed, and 95% confidence intervals were declared at a value of 5% significance level.

Result: The incidence of adverse perinatal outcomes was higher in the exposed women than in the nonexposed women (56% versus 16%). Contrasted with the nonexposed, women exposed to maternal near-misses had a higher incidence of stillbirth (22% vs. 0.5%), low birth weight (13% vs. 3%), and preterm birth (12% vs. 2%). After adjusting for confounders, exposed women had a twofold increased risk of adverse perinatal outcomes compared to nonexposed women. Delivery mode, delay in seeking care, transport mode, and delay in receiving treatment were the risk factors for negative pregnancy outcomes.

Conclusion: In exposed women, a higher incidence of adverse perinatal outcomes was linked to aforementioned risk factors. Evidence-based practice intended to decrease delays in providing maternal care services does indeed improve perinatal outcomes.

Citing Articles

Prevalence, underlying causes, and determinants of maternal near miss in Ethiopia: a systematic review and meta-analysis.

Tesfay N, Hailu G, Begna D, Habtetsion M, Taye F, Woldeyohannes F Front Med (Lausanne). 2024; 11:1393118.

PMID: 39440038 PMC: 11493713. DOI: 10.3389/fmed.2024.1393118.

References

Pacagnella R, Cecatti J, Osis M, Souza J . The role of delays in severe maternal morbidity and mortality: expanding the conceptual framework. Reprod Health Matters. 2012; 20(39):155-63. DOI: 10.1016/S0968-8080(12)39601-8. View

Kasahun A, Wako W . Predictors of maternal near miss among women admitted in Gurage zone hospitals, South Ethiopia, 2017: a case control study. BMC Pregnancy Childbirth. 2018; 18(1):260. PMC: 6019215. DOI: 10.1186/s12884-018-1903-1. View

Kiruja J, Osman F, Egal J, Essen B, Klingberg-Allvin M, Erlandsson K . Maternal near-miss and death incidences - Frequencies, causes and the referral chain in Somaliland: A pilot study using the WHO near-miss approach. Sex Reprod Healthc. 2017; 12:30-36. DOI: 10.1016/j.srhc.2017.02.003. View

Yeshitila Y, Daniel B, Desta M, Kassa G . Obstructed labor and its effect on adverse maternal and fetal outcomes in Ethiopia: A systematic review and meta-analysis. PLoS One. 2022; 17(9):e0275400. PMC: 9524671. DOI: 10.1371/journal.pone.0275400. View

Liyew E, Yalew A, Afework M, Essen B . Distant and proximate factors associated with maternal near-miss: a nested case-control study in selected public hospitals of Addis Ababa, Ethiopia. BMC Womens Health. 2018; 18(1):28. PMC: 5787253. DOI: 10.1186/s12905-018-0519-y. View

Tenaw S, Assefa N, Mulatu T, Tura A . Maternal near miss among women admitted in major private hospitals in eastern Ethiopia: a retrospective study. BMC Pregnancy Childbirth. 2021; 21(1):181. PMC: 7934366. DOI: 10.1186/s12884-021-03677-w. View

Zanardi D, Parpinelli M, Haddad S, Costa M, Sousa M, Leite D . Adverse perinatal outcomes are associated with severe maternal morbidity and mortality: evidence from a national multicentre cross-sectional study. Arch Gynecol Obstet. 2018; 299(3):645-654. DOI: 10.1007/s00404-018-5004-1. View

Habte A, Lukas K, Melis T, Tamene A, Sahle T, Hailu M . Determinants of neonatal near miss among neonates admitted to public hospitals in Southern Ethiopia, 2021: A case-control study. PLoS One. 2022; 17(5):e0268041. PMC: 9075625. DOI: 10.1371/journal.pone.0268041. View

Qureshi Z, Millum J, Blencowe H, Kelley M, Fottrell E, Lawn J . Stillbirth should be given greater priority on the global health agenda. BMJ. 2015; 351:h4620. PMC: 4707511. DOI: 10.1136/bmj.h4620. View

10.

Sayinzoga F, Bijlmakers L, van der Velden K, van Dillen J . Severe maternal outcomes and quality of care at district hospitals in Rwanda- a multicentre prospective case-control study. BMC Pregnancy Childbirth. 2017; 17(1):394. PMC: 5702108. DOI: 10.1186/s12884-017-1581-4. View

11.

Santos J, Pileggi-Castro C, Camelo Jr J, Silva A, Duran P, Serruya S . Neonatal near miss: a systematic review. BMC Pregnancy Childbirth. 2015; 15:320. PMC: 4667407. DOI: 10.1186/s12884-015-0758-y. View

12.

Berhe A, Ilesanmi A, Aimakhu C, Mulugeta A . Effect of pregnancy induced hypertension on adverse perinatal outcomes in Tigray regional state, Ethiopia: a prospective cohort study. BMC Pregnancy Childbirth. 2020; 20(1):7. PMC: 6938605. DOI: 10.1186/s12884-019-2708-6. View

13.

Dessalegn F, Astawesegn F, Chea Hankalo N . Factors Associated with Maternal Near Miss among Women Admitted in West Arsi Zone Public Hospitals, Ethiopia: Unmatched Case-Control Study. J Pregnancy. 2020; 2020:6029160. PMC: 7352151. DOI: 10.1155/2020/6029160. View

14.

Domingues R, Dias M, Schilithz A, Leal M . Factors associated with maternal near miss in childbirth and the postpartum period: findings from the birth in Brazil National Survey, 2011-2012. Reprod Health. 2016; 13(Suppl 3):115. PMC: 5073804. DOI: 10.1186/s12978-016-0232-y. View

15.

Aliyi A, Deyessa N, Dilnessie M . Effect of maternal near miss on neonatal mortality in selected hospitals: Prospective cohort study, Southeast Ethiopia. SAGE Open Med. 2021; 9:20503121211042219. PMC: 8411626. DOI: 10.1177/20503121211042219. View

16.

Adeoye I, Onayade A, Fatusi A . Incidence, determinants and perinatal outcomes of near miss maternal morbidity in Ile-Ife Nigeria: a prospective case control study. BMC Pregnancy Childbirth. 2013; 13:93. PMC: 3651395. DOI: 10.1186/1471-2393-13-93. View

17.

Sisay Woldeyes W, Asefa D, Muleta G . Incidence and determinants of severe maternal outcome in Jimma University teaching hospital, south-West Ethiopia: a prospective cross-sectional study. BMC Pregnancy Childbirth. 2018; 18(1):255. PMC: 6011243. DOI: 10.1186/s12884-018-1879-x. View

18.

Liyew E, Yalew A, Afework M, Essen B . Maternal near-miss and the risk of adverse perinatal outcomes: a prospective cohort study in selected public hospitals of Addis Ababa, Ethiopia. BMC Pregnancy Childbirth. 2018; 18(1):345. PMC: 6106830. DOI: 10.1186/s12884-018-1983-y. View

19.

Syoum F, Abreha G, Teklemichael D, Chekole M . Fetomaternal Outcomes and Associated Factors among Mothers with Hypertensive Disorders of Pregnancy in Suhul Hospital, Northwest Tigray, Ethiopia. J Pregnancy. 2022; 2022:6917009. PMC: 9668464. DOI: 10.1155/2022/6917009. View

20.

Goba G, Tsegay H, Gebregergs G, Mitiku M, Kim K, Alemayehu M . A facility-based study of factors associated with perinatal mortality in Tigray, northern Ethiopia. Int J Gynaecol Obstet. 2018; 141(1):113-119. DOI: 10.1002/ijgo.12438. View