Factors Associated with Maternal Near-Miss (MNM) Among Women in Eastern Province, Rwanda

Abstract

The World Health Organization (WHO) defines Maternal Near-Miss (MNM) as a situation where a woman nearly dies but survives a life-threatening condition during pregnancy and childbirth. Maternal mortality rate, used to gauge obstetric care quality globally, can aid in achieving the SDG target 3.1, which aims to lower the global maternal mortality ratio below 70 per 100,000 live births. A retrospective cross-sectional design was employed to assess the prevalence and factors associated with MNM at Kirehe District Hospital in Rwanda. 350 women admitted to the hospital's maternity units from January to December 2020 were sampled. Data from patients' medical records was extracted, focusing on demographics, MNM characteristics based on WHO criteria, and clinical outcomes. Statistical analysis was performed with SPSS version 21. Women aged 20-29 constituted the majority, primarily with primary education and working in agriculture. From the 350, 6.3% encountered severe postpartum haemorrhage, 3.1% severe preeclampsia, and 2% uterine rupture. 53.7% underwent cesarean section, 38.9% had vaginal deliveries, and 4.9% experienced abortion. The MNM prevalence for 2020 was 10.2%. Age and marital status correlated with MNM; younger, married, or widowed women exhibited higher MNM rates. Among maternal factors, only labor duration significantly related to MNM. The MNM rate at Kirehe District Hospital remains a concern. Cesarean section was predominant. Age and marital status played pivotal roles in MNM occurrences. Access to enhanced maternal healthcare and improved labor monitoring can mitigate severe complications.