Risk Factors for Maternal Near Miss in Gaza Strip: A Case-Control Study

Abstract

Background: Maternal near miss refers to pregnant women with severe life-threatening conditions who nearly die but, with good luck or good care, survive. This study aimed to determine the risk factors for maternal near-miss in Gaza Strip. Methods: A case-control study was used and 486 women who gave birth in 2020 were involved. The case group consisted of 243 identified near-miss cases, and the control group consisted of 243 women who had normal pregnancies and deliveries. The Maternal Near Miss Identification Checklist of the WHO Technical Working Group (2007) was used to collect data. Results: The total number of deliveries was 34,974, and the number of identified near-miss cases was 243, with a rate of 6.9/1000 delivery. The results showed that 70.8% of cases had severe hemorrhage, and 16% had hypertensive disorders at admission. Significant (p ˂0.05) risk factors associated with near miss included preterm labor ≤ 36 weeks [OR 25.081, 95% CI (7.736 – 81.315)], previous obstetric problems [OR 5.144, 95% CI (2.090 – 12.663)], previous cesarean section [OR 3.661, 95% CI (1.726 – 7.610)], history of abortion [OR 3.348, 95% CI (1.697 – 6.606)], previous medical problems [OR 2.317, 95% CI (1.490 – 3.603)], and prim parity [OR 1.770, 95% CI (1.071 – 2.923),]. Conclusion: The study concluded that more efforts are needed to improve maternal health services in Gaza and emphasized the imperative need to train obstetricians and midwives on emergency obstetric management.