Non-obstetric causes of severe maternal complications: a secondary analysis of the Nigeria Near-miss and Maternal Death Survey
dc.contributor.author | Adeniran, Abiodun | |
dc.contributor.author | Ocheke, Amaka | |
dc.contributor.author | Nwachukwu, Dumm | |
dc.contributor.author | Adewole, Nathaniel | |
dc.contributor.author | Ageda, Ben | |
dc.contributor.author | Onile, Temitope | |
dc.contributor.author | Umezulike, A.C | |
dc.contributor.author | Aboyeji, Peter | |
dc.contributor.author | Oladapo, Olufemi | |
dc.date.accessioned | 2019-10-21T08:00:03Z | |
dc.date.available | 2019-10-21T08:00:03Z | |
dc.date.issued | 2019-03-21 | |
dc.description.abstract | Objective 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 non- obstetric 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.sponsorship | Funding The original research that generated the data for this secondary analysis and the publication of this secondary analysis were funded by the UNDP-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.other | DOI: 10.1111/1471-0528.15623 | |
dc.identifier.uri | http://hdl.handle.net/123456789/2877 | |
dc.language.iso | en | en_US |
dc.publisher | Royal College of Obstetricians and gynaecologists | en_US |
dc.subject | Coincidental causes | en_US |
dc.subject | Indirect causes | en_US |
dc.subject | Maternal death | en_US |
dc.subject | Maternal near-miss | en_US |
dc.subject | Non-obstetric complications | en_US |
dc.subject | Severe maternal outcome | en_US |
dc.title | Non-obstetric causes of severe maternal complications: a secondary analysis of the Nigeria Near-miss and Maternal Death Survey | en_US |
dc.type | Article | en_US |
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