Network for Surveillance of Severe Maternal Morbidity: a powerful national collaboration generating data on maternal health outcomes and care
Network for Surveillance of Severe Maternal Morbidity: a powerful national collaboration generating data on maternal health outcomes and care
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DOI：
10.1111/1471-0528.13614
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发表时间：
2016-05-01
影响因子：
5.8
通讯作者：
Passini, R., Jr.
中科院分区：
文献类型：
--
作者：
Cecatti, J. G.;Costa, M. L.;Passini, R., Jr.
目的了解孕产妇重度发病（SMM）的病例、特点，并测试扩大世界卫生组织标准的可行性，以确定妇女在一个更坏的结果的风险。设计多中心横断面研究。设置27个转诊妇产医院从所有地区的巴西。人口例SMM确定82 388分娩妇女超过1-方法采用世界卫生组织的潜在危及生命的条件（PLTC）和产妇未遂（MNM）标准进行前瞻性监测，确定和评估严重发病或死亡的病例。发病率和护理延误的主要原因。结果在9555例SMM中，有140例死亡和770例MNM。产妇并发症的主要原因是高血压病。MNM条件的标准更频繁的严重程度的结果增加，所有合并在超过75%的孕产妇deaths.ConclusionsThis研究确定了约9.5%的MNM或死亡的所有情况下，发展任何严重的孕产妇并发症。通过有组织的合作和适当的研究方案，可以成功实施SMM监测的多中心研究，即使在低收入和中等收入环境中，在巴西的一个医院网络中，对严重孕产妇发病率的监测被证明是可能的。在巴西的一个医院网络中，产妇发病率被证明是可能的。
ObjectiveTo identify cases of severe maternal morbidity (SMM) during pregnancy and childbirth, their characteristics, and to test the feasibility of scaling up World Health Organization criteria for identifying women at risk of a worse outcome.DesignMulticentre cross-sectional study.SettingTwenty-seven referral maternity hospitals from all regions of Brazil.PopulationCases of SMM identified among 82 388 delivering women over a 1-year period.MethodsProspective surveillance using the World Health Organization's criteria for potentially life-threatening conditions (PLTC) and maternal near-miss (MNM) identified and assessed cases with severe morbidity or death.Main outcome measuresIndicators of maternal morbidity and mortality; sociodemographic, clinical and obstetric characteristics; gestational and perinatal outcomes; main causes of morbidity and delays in care.ResultsAmong 9555 cases of SMM, there were 140 deaths and 770 cases of MNM. The main determining cause of maternal complication was hypertensive disease. Criteria for MNM conditions were more frequent as the severity of the outcome increased, all combined in over 75% of maternal deaths.ConclusionsThis study identified around 9.5% of MNM or death among all cases developing any severe maternal complication. Multicentre studies on surveillance of SMM, with organised collaboration and adequate study protocols can be successfully implemented, even in low-income and middle-income settings, generating important information on maternal health and care to be used to implement appropriate health policies and interventions.Tweetable abstractSurveillance of severe maternal morbidity was proved to be possible in a hospital network in Brazil.Tweetable abstract Surveillance of severe maternal morbidity was proved to be possible in a hospital network in Brazil.