MENDONÇA, D. Í. M.; FERNANDES JÚNIOR, J. T.; SOUZA, T. H. S. C.; http://lattes.cnpq.br/4444956455755133; http://lattes.cnpq.br/7472174840838177; http://lattes.cnpq.br/9170672242855116; MENDONÇA, Durval Ícaro Martins.; FERNANDES JÚNIOR, José Tóvenis..; SOUZA, Tházio Henrique Soares Cardoso de.
Resumen:
To determine the frequency and describe the risk factors associated with the events of
maternal near miss in a school maternity in Paraíba. Methods: The authors conducted a cross-
sectional, descriptive, observational, from July 2009 to June 2010, through secondary analysis of a
database collected from a multicenter, selecting the patients admitted to the Health Institute Elpídio
de Almeida (ISEA), in Campina Grande, Paraiba, with severe maternal morbidity criteria. 565
patients were included, and the following maternal variables were assessed: biological,
sociodemographic, obstetric, clinical and delays in obstetric care. The cases were classified as
potentially life-threatening condition (SMM) and maternal near miss (MNM). The cases were
classified as potentially life-threatening condition or severe maternal morbidity (MMG) and
maternal near miss (NM). The original database was exported to the statistical software Epi-Info
7.1. A bivariate analysis was performed using chi-square tests of association and Fisher's exact test,
as appropriate, calculating the prevalence ratio (PR) with its confidence interval of 95% (95%). It
was also conducted multivariate logistic regression to identify factors associated with near miss
outcome after controlling potentially confounding variables, only persisting variables associated to
that outcome with 5% significance level. Results: In this study, the near miss ratio was 7.72 cases
per 1,000 live births (LB), while the MMG ratio was 77.81 cases per 1,000 LB (total of 6,605 LB
on ISEA during the study period). Compared with cases of MMG, statistically significant
association of NM was found in the bivariate analysis on subjects with age higher than 30 years,
previous cesarean deliveries, lack of prenatal care during pregnancy, multiparity, presence of the
first delay, bleeding complications, absence of hypertensive complications, presence of other
systemic complications. The risk of developing near miss persisted high even after controlling
potential confounding factors in patients with first delay (OR: 3.54; 95% CI: 1.62 - 7.77), bleeding
complications (OR: 5.54; 95% CI: 2.5 - 12.33), other systemic disorders (OR: 33.7; 95% CI 15.56 -
72.99). Conclusion: Severe morbidity and maternal near miss events occurred in a significant
number of patients admitted to ISEA. The determining factors associated with these conditions
were: patients delay associated with seeking health services, bleeding complications and other
systemic disorders.