Abstract
Understanding maternal morbidity and its determinants can help identify opportunities to prevent obstetric complications and improvements for maternal health. This study was conducted to determine the prevalence of severe maternal morbidity (SMM) and the associated factors. A hospital-based cross-sectional study was conducted at Koshi Hospital, Nepal, from January to March 2020. All women who met the inclusion criteria of age ≥18 years of age, Morang residents of Nepalese nationality, had received routine antenatal care, and given birth at Koshi Hospital were recruited consecutively. The World Health Organization criteria were used to identify the women with SMM. A multiple logistic regression analysis was performed. Overall, 346 women were recruited. The prevalence of SMM was 6.6%. Among the SMM cases, the most frequently occurring SMM conditions were hypertensive disorders (12, 56.5%), hemorrhagic disorders (6, 26.1%), and severe management indicators (8, 34.8%). Women with no or primary education (adjusted odds ratio: 0.10, 95% confidence interval: 0.01, 0.76) decreased the odds of SMM compared to secondary education. The approximately 7% prevalence of SMM correlated with global studies. Maternal education was significantly associated with SMM. If referral hospitals were aware of the expected prevalence of potentially life-threatening maternal conditions, they could plan to avert future reproductive complications.
Highlights
Maternal mortality is a public health problem studied worldwide [1], but the existing research on maternal mortality represents only a fraction of the problem [2]
This study was conducted to determine the prevalence of severe maternal morbidity (SMM) and the associated factors
The World Health Organization (WHO) working group has recommended the use of the term Maternal near-miss (MNM) as it best reflects the severity of events
Summary
Maternal mortality is a public health problem studied worldwide [1], but the existing research on maternal mortality represents only a fraction of the problem [2]. Maternal near-miss (MNM) and severe maternal morbidity (SMM) are new strategic indicators of maternal health conditions [4]. The World Health Organization (WHO) adopted and defined MNM and SMM standard criteria in 2009 [5]. The WHO working group has recommended the use of the term MNM as it best reflects the severity of events. The WHO uses clinical-, laboratory-, and management-based criteria to identify MNM [7]. Understanding maternal morbidity and its determinants can help identify opportunities to prevent obstetric complications and improvements for maternal health. This study was conducted to determine the prevalence of severe maternal morbidity (SMM) and the associated factors
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