Women with maternal near-miss in the intensive care unit in Yangzhou, China: a 5-year retrospective study

Abstract Background Analysis of “maternal near-misses” is expected to facilitate assessment of the quality of maternity care in health facilities. Therefore, this study aimed to investigate incidence, risk factors and causes of maternal near-misses (MNM) admitted to the intensive care unit (ICU) wit...

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Autores principales:	Ying Chen, Jiaoyang Shi, Yuting Zhu, Xiang Kong, Yang Lu, Yanru Chu, Miskatul Mustafa Mishu
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Maternal near-miss Maternal mortality Maternal morbidity Intensive care unit Gynecology and obstetrics RG1-991
Acceso en línea:	https://doaj.org/article/90b05172b1b0418ca31af5d42ae9b594
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spelling	oai:doaj.org-article:90b05172b1b0418ca31af5d42ae9b5942021-11-21T12:32:44ZWomen with maternal near-miss in the intensive care unit in Yangzhou, China: a 5-year retrospective study10.1186/s12884-021-04237-y1471-2393https://doaj.org/article/90b05172b1b0418ca31af5d42ae9b5942021-11-01T00:00:00Zhttps://doi.org/10.1186/s12884-021-04237-yhttps://doaj.org/toc/1471-2393Abstract Background Analysis of “maternal near-misses” is expected to facilitate assessment of the quality of maternity care in health facilities. Therefore, this study aimed to investigate incidence, risk factors and causes of maternal near-misses (MNM) admitted to the intensive care unit (ICU) within five years by using the World Health Organization’s MNM approach. Methods A five-year retrospective study was conducted in Subei People’s Hospital of Yangzhou, Jiangsu Province from January 1, 2015 to December 31, 2019. Risk factors in 65 women with MNM in the intensive care unit (ICU) were explored by using chi-square tests and multivariable logistic regression analysis. Causes and interventions in MNM were investigated by descriptive analysis. Results Average maternal near-miss incidence ratio (MNMIR) for ICU admission was 3.5 per 1000 live births. Average maternal mortality ratio (MMR) was 5 per 100,000 live births. MI for all MNM was 0.7%. Steady growth of MNMIR in ICU was witnessed in the five-year study period. Women who were referred from other hospitals (aOR 3.32; 95%CI 1.40–7.32) and had cesarean birth (aOR 4.96; 95%CI 1.66–14.86) were more likely to be admitted in ICU. Neonates born to women with MNM admitted in ICU had lower birthweight (aOR 5.41; 95%CI 2.53–11.58) and Apgar score at 5 min (aOR 6.39; 95%CI 2.20–18.55) compared with women with MNM outside ICU. ICU admission because of MNM occurred mostly postpartum (n = 63; 96.9%). Leading direct obstetric causes of MNM admitted in ICU were hypertensive diseases of pregnancy (n = 24; 36.9%), followed by postpartum hemorrhage (n = 14; 21.5%), while the leading indirect obstetric cause was heart diseases (n = 3; 4.6%). Conclusions Risk factors that were associated with MNM in ICU were referral and cesarean birth. Hypertensive disease of pregnancy and postpartum hemorrhage were the main obstetric causes of MNM in ICU. These findings would provide guidance to improve professional skills of primary health care providers and encourage vaginal birth in the absence of medical indications for cesarean birth.Ying ChenJiaoyang ShiYuting ZhuXiang KongYang LuYanru ChuMiskatul Mustafa MishuBMCarticleMaternal near-missMaternal mortalityMaternal morbidityIntensive care unitGynecology and obstetricsRG1-991ENBMC Pregnancy and Childbirth, Vol 21, Iss 1, Pp 1-9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Maternal near-miss Maternal mortality Maternal morbidity Intensive care unit Gynecology and obstetrics RG1-991
spellingShingle	Maternal near-miss Maternal mortality Maternal morbidity Intensive care unit Gynecology and obstetrics RG1-991 Ying Chen Jiaoyang Shi Yuting Zhu Xiang Kong Yang Lu Yanru Chu Miskatul Mustafa Mishu Women with maternal near-miss in the intensive care unit in Yangzhou, China: a 5-year retrospective study
description	Abstract Background Analysis of “maternal near-misses” is expected to facilitate assessment of the quality of maternity care in health facilities. Therefore, this study aimed to investigate incidence, risk factors and causes of maternal near-misses (MNM) admitted to the intensive care unit (ICU) within five years by using the World Health Organization’s MNM approach. Methods A five-year retrospective study was conducted in Subei People’s Hospital of Yangzhou, Jiangsu Province from January 1, 2015 to December 31, 2019. Risk factors in 65 women with MNM in the intensive care unit (ICU) were explored by using chi-square tests and multivariable logistic regression analysis. Causes and interventions in MNM were investigated by descriptive analysis. Results Average maternal near-miss incidence ratio (MNMIR) for ICU admission was 3.5 per 1000 live births. Average maternal mortality ratio (MMR) was 5 per 100,000 live births. MI for all MNM was 0.7%. Steady growth of MNMIR in ICU was witnessed in the five-year study period. Women who were referred from other hospitals (aOR 3.32; 95%CI 1.40–7.32) and had cesarean birth (aOR 4.96; 95%CI 1.66–14.86) were more likely to be admitted in ICU. Neonates born to women with MNM admitted in ICU had lower birthweight (aOR 5.41; 95%CI 2.53–11.58) and Apgar score at 5 min (aOR 6.39; 95%CI 2.20–18.55) compared with women with MNM outside ICU. ICU admission because of MNM occurred mostly postpartum (n = 63; 96.9%). Leading direct obstetric causes of MNM admitted in ICU were hypertensive diseases of pregnancy (n = 24; 36.9%), followed by postpartum hemorrhage (n = 14; 21.5%), while the leading indirect obstetric cause was heart diseases (n = 3; 4.6%). Conclusions Risk factors that were associated with MNM in ICU were referral and cesarean birth. Hypertensive disease of pregnancy and postpartum hemorrhage were the main obstetric causes of MNM in ICU. These findings would provide guidance to improve professional skills of primary health care providers and encourage vaginal birth in the absence of medical indications for cesarean birth.
format	article
author	Ying Chen Jiaoyang Shi Yuting Zhu Xiang Kong Yang Lu Yanru Chu Miskatul Mustafa Mishu
author_facet	Ying Chen Jiaoyang Shi Yuting Zhu Xiang Kong Yang Lu Yanru Chu Miskatul Mustafa Mishu
author_sort	Ying Chen
title	Women with maternal near-miss in the intensive care unit in Yangzhou, China: a 5-year retrospective study
title_short	Women with maternal near-miss in the intensive care unit in Yangzhou, China: a 5-year retrospective study
title_full	Women with maternal near-miss in the intensive care unit in Yangzhou, China: a 5-year retrospective study
title_fullStr	Women with maternal near-miss in the intensive care unit in Yangzhou, China: a 5-year retrospective study
title_full_unstemmed	Women with maternal near-miss in the intensive care unit in Yangzhou, China: a 5-year retrospective study
title_sort	women with maternal near-miss in the intensive care unit in yangzhou, china: a 5-year retrospective study
publisher	BMC
publishDate	2021
url	https://doaj.org/article/90b05172b1b0418ca31af5d42ae9b594
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Women with maternal near-miss in the intensive care unit in Yangzhou, China: a 5-year retrospective study

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