Adeniran, A.S., Ocheke, A.N., Nwachukwu, D., Adewole, N., Ageda, B., Onile, TNon-obstetric causes of severe maternal complications: a secondary analysis of the Nigeria Near-Miss and Maternal Death Survey.

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dc.contributor.authorAdeniran, AS
dc.contributor.authorOcheke, AN
dc.contributor.authorNwachukwu, D
dc.contributor.authorAdewole, N
dc.contributor.authorAgeda, B
dc.contributor.authorOnile, T
dc.contributor.authorUmezulike, AC
dc.contributor.authorAboyeji, A.P
dc.contributor.authorOladapo, OT
dc.contributor.authorNigeria Near Miss and Maternal Death Surveillance Network
dc.date.accessioned2023-04-12T10:12:01Z
dc.date.available2023-04-12T10:12:01Z
dc.date.issued2019-03-21
dc.description.abstractObjective To evaluate the burden, causes and outcomes of severe non-obstetric maternal complications in Nigerian public tertiary hospitals. Design Secondary analysis of a nationwide cross-sectional study. Setting Forty-two tertiary health facilities. Population Women admitted with complications during pregnancy, childbirth or puerperium. Methods All cases of severe maternal outcome (SMO: maternal near-miss or maternal death) due to non-obstetric causes were prospectively identified over a 1-year period. Maternal near-miss was defined using organ-system dysfunction (WHO), clinical, or management-based criteria. Main outcome measures Causes and contributions of non-obstetric complications to SMO; fetal and neonatal outcomes; health service events associated with non-obstetric complications; and mortality index (% of maternal death/SMO). Results Of 100 107 women admitted with complications, 9401 (9.4%) were for non-obstetric causes; and 4.0% (375/9401) suffered severe non-obstetric complications. Of the 375 cases of severe nonobstetric complications, 48.8% (183/375) were near-misses and 51.2% (192/375) were maternal deaths. Severe anaemia unrelated to haemorrhage contributed 61.2% of near-misses and 32.8% of maternal deaths. The highest mortality indices were observed for cancer (91.7%), hepatic diseases (81.8%) and HIV/AIDS/HIV wasting syndrome (80.4%). Fatality was significantly high with extremes of age and no formal education. Regarding organ dysfunctions, neurological (77.1%) and cardiovascular (75.0%) dysfunctions had the highest mortality indices. Perinatal mortality was 65.9%. Time from diagnosis of severe non-obstetric complications to review by senior medical personnel, and to definitive intervention was <30 minutes in 30.2% and 29.8% of women with SMO, respectively. However, over 240 minutes elapsed between diagnosis and definitive intervention in more than one-third of women with SMO. Conclusion Non-obstetric complications are associated with poorer pregnancy outcomes and deserve attention similar to that accorded obstetric complications.en_US
dc.description.sponsorshipUNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), a co-sponsored programme executed by the World Health Organization (WHO).en_US
dc.identifier.citationAdeniran, A.S., Ocheke, A.N., Nwachukwu, D., Adewole, N., Ageda, B., Onile, T., Umezulike, A.C., Aboyeji, A.P. & Oladapo, O.T., for the Nigeria Near-Miss and Maternal Death Surveillance Network. (2019): Non-obstetric causes of severe maternal complications: a secondary analysis of the Nigeria Near-Miss and Maternal Death Survey. BJOG An international Journal of Obstetrics and Gynaecology 126(Suppl 3):41-48.en_US
dc.identifier.urihttps://obgyn.onlinelibrary.wiley.com/ toc/14710528/2019/126/S3
dc.identifier.urihttps://uilspace.unilorin.edu.ng/handle/20.500.12484/9091
dc.language.isoenen_US
dc.publisherRoyal College of Obstetricians and Gynaecologistsen_US
dc.subjectCoincidental causes; indirect causes; maternal death; maternal near-miss; non-obstetric complications; severe maternal outcomeen_US
dc.titleAdeniran, A.S., Ocheke, A.N., Nwachukwu, D., Adewole, N., Ageda, B., Onile, TNon-obstetric causes of severe maternal complications: a secondary analysis of the Nigeria Near-Miss and Maternal Death Survey.en_US
dc.typeArticleen_US

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