Prognostic factors of maternal near miss events and maternal deaths in a tertiary healthcare facility in India

Abstract

To study maternal near miss (MNM) and maternal mortality to identify rectifiable risk factors. The present cross-sectional retrospective study included pregnant women who experienced acute life-threatening pregnancy-related adverse events at Deen Dayal Upadhyay hospital, New Delhi, India, between September 1, 2009, and August 31, 2011. Patient data were analyzed to investigate factors associated with MNM events and maternal deaths. There were 369 patients included, and 302 MNM events and 67 maternal deaths were recorded. The recorded causes of MNM events included hemorrhage, hypertensive disorders, severe anemia with cardiac failure, organ failure, and infection in 192 (63.6%), 62 (20.5%), 13 (4.3%), 8 (2.6%), and 8 (2.6%) patients, respectively. Higher rates of anemia (P=0.007) and infection (P=0.007) were recorded among patients in the maternal death group than the MNMN group. Hemorrhage and hypertension were major causes of MNM events and are likely major barriers to reducing maternal mortality in low-income countries. Anemia and infection were significant prognostic factors of maternal death in the present study. MNM could be used as surrogate for maternal death in the provision of standard obstetric care.