The WHO maternal near-miss approach and the maternal severity index model (MSI): tools for assessing the management of severe maternal morbidity.

<h4>Objectives</h4>To validate the WHO maternal near-miss criteria and develop a benchmark tool for severe maternal morbidity assessments.<h4>Methods</h4>In a multicenter cross-sectional study implemented in 27 referral maternity hospitals in Brazil, a one-year prospective su...

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Autores principales:	Joao Paulo Souza, Jose Guilherme Cecatti, Samira M Haddad, Mary Angela Parpinelli, Maria Laura Costa, Leila Katz, Lale Say, Brazilian Network for Surveillance of Severe Maternal Morbidity Group, Brazilian Network for Surveillance of Severe Maternal Morbidity
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2012
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/09134e37efc14fe48aa96d934ce6a48b
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spelling	oai:doaj.org-article:09134e37efc14fe48aa96d934ce6a48b2021-11-18T07:07:07ZThe WHO maternal near-miss approach and the maternal severity index model (MSI): tools for assessing the management of severe maternal morbidity.1932-620310.1371/journal.pone.0044129https://doaj.org/article/09134e37efc14fe48aa96d934ce6a48b2012-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/22952897/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Objectives</h4>To validate the WHO maternal near-miss criteria and develop a benchmark tool for severe maternal morbidity assessments.<h4>Methods</h4>In a multicenter cross-sectional study implemented in 27 referral maternity hospitals in Brazil, a one-year prospective surveillance on severe maternal morbidity and data collection was carried out. Diagnostic accuracy tests were used to assess the validity of the WHO maternal near-miss criteria. Binary logistic regression was used to model the death probability among women with severe maternal complications and benchmark the management of severe maternal morbidity.<h4>Results</h4>Of the 82,388 women having deliveries in the participating health facilities, 9,555 women presented pregnancy-related complications, including 140 maternal deaths and 770 maternal near misses. The WHO maternal near-miss criteria were found to be accurate and highly associated with maternal deaths (Positive likelihood ratio 106.8 (95% CI 99.56-114.6)). The maternal severity index (MSI) model was developed and found to able to describe the relationship between life-threatening conditions and mortality (Area under the ROC curve: 0.951 (95% CI 0.909-0.993)).<h4>Conclusion</h4>The identification of maternal near-miss cases using the WHO list of pregnancy-related life-threatening conditions was validated. The MSI model can be used as a tool for benchmarking the performance of health services managing women with severe maternal complications and provide case-mix adjustment.Joao Paulo SouzaJose Guilherme CecattiSamira M HaddadMary Angela ParpinelliMaria Laura CostaLeila KatzLale SayBrazilian Network for Surveillance of Severe Maternal Morbidity GroupBrazilian Network for Surveillance of Severe Maternal MorbidityPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 7, Iss 8, p e44129 (2012)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Joao Paulo Souza Jose Guilherme Cecatti Samira M Haddad Mary Angela Parpinelli Maria Laura Costa Leila Katz Lale Say Brazilian Network for Surveillance of Severe Maternal Morbidity Group Brazilian Network for Surveillance of Severe Maternal Morbidity The WHO maternal near-miss approach and the maternal severity index model (MSI): tools for assessing the management of severe maternal morbidity.
description	<h4>Objectives</h4>To validate the WHO maternal near-miss criteria and develop a benchmark tool for severe maternal morbidity assessments.<h4>Methods</h4>In a multicenter cross-sectional study implemented in 27 referral maternity hospitals in Brazil, a one-year prospective surveillance on severe maternal morbidity and data collection was carried out. Diagnostic accuracy tests were used to assess the validity of the WHO maternal near-miss criteria. Binary logistic regression was used to model the death probability among women with severe maternal complications and benchmark the management of severe maternal morbidity.<h4>Results</h4>Of the 82,388 women having deliveries in the participating health facilities, 9,555 women presented pregnancy-related complications, including 140 maternal deaths and 770 maternal near misses. The WHO maternal near-miss criteria were found to be accurate and highly associated with maternal deaths (Positive likelihood ratio 106.8 (95% CI 99.56-114.6)). The maternal severity index (MSI) model was developed and found to able to describe the relationship between life-threatening conditions and mortality (Area under the ROC curve: 0.951 (95% CI 0.909-0.993)).<h4>Conclusion</h4>The identification of maternal near-miss cases using the WHO list of pregnancy-related life-threatening conditions was validated. The MSI model can be used as a tool for benchmarking the performance of health services managing women with severe maternal complications and provide case-mix adjustment.
format	article
author	Joao Paulo Souza Jose Guilherme Cecatti Samira M Haddad Mary Angela Parpinelli Maria Laura Costa Leila Katz Lale Say Brazilian Network for Surveillance of Severe Maternal Morbidity Group Brazilian Network for Surveillance of Severe Maternal Morbidity
author_facet	Joao Paulo Souza Jose Guilherme Cecatti Samira M Haddad Mary Angela Parpinelli Maria Laura Costa Leila Katz Lale Say Brazilian Network for Surveillance of Severe Maternal Morbidity Group Brazilian Network for Surveillance of Severe Maternal Morbidity
author_sort	Joao Paulo Souza
title	The WHO maternal near-miss approach and the maternal severity index model (MSI): tools for assessing the management of severe maternal morbidity.
title_short	The WHO maternal near-miss approach and the maternal severity index model (MSI): tools for assessing the management of severe maternal morbidity.
title_full	The WHO maternal near-miss approach and the maternal severity index model (MSI): tools for assessing the management of severe maternal morbidity.
title_fullStr	The WHO maternal near-miss approach and the maternal severity index model (MSI): tools for assessing the management of severe maternal morbidity.
title_full_unstemmed	The WHO maternal near-miss approach and the maternal severity index model (MSI): tools for assessing the management of severe maternal morbidity.
title_sort	who maternal near-miss approach and the maternal severity index model (msi): tools for assessing the management of severe maternal morbidity.
publisher	Public Library of Science (PLoS)
publishDate	2012
url	https://doaj.org/article/09134e37efc14fe48aa96d934ce6a48b
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The WHO maternal near-miss approach and the maternal severity index model (MSI): tools for assessing the management of severe maternal morbidity.

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