Anaesthesia providers and maternal mortality in Africa – Authors' reply

Bruce M Biccard,David Bishop,Robert A Dyer,Rupert M Pearse

doi:10.1016/s2214-109x(19)30282-7

Abstract

We thank J Matthew Kynes and Mark W Newton for their interest in our Article describing the obstetric cohort1 of the African Surgical Outcomes Study (ASOS).2 In the ASOS cohort, no difference was seen in maternal mortality between physician and non-physician anaesthesia providers.1 However, anaesthesia complications were independently associated with maternal mortality, and the point estimate for maternal mortality favoured risk associated with non-physician anaesthesia providers.1 Kynes and Newton correctly emphasise that this association does not necessarily imply that the level of the anaesthesia provider is associated with maternal mortality in Africa, especially because this association was not explored in the ASOS cohort.

Highlights

In the African Surgical Outcomes Study (ASOS) cohort, no difference was seen in maternal mortality between physician and non-physician anaesthesia providers.[1]
Anaesthesia complications were independently associated with maternal mortality, and the point estimate for maternal mortality favoured risk associated with non-physician anaesthesia providers.[1]
Kynes and Newton correctly emphasise that this association does not necessarily imply that the level of the anaesthesia provider is associated with maternal mortality in Africa, especially because this association was not explored in the ASOS cohort.[2]