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3
rd
International Congress on
Annual Summit on
October 02-03, 2017 Atlanta,USA
&
Microbiology and Pharmaceutical Microbiology
Sexual & Reproductive Health
Journal of sexual and Reproductive medicine | Volume.1, Issue.2
Determinants of maternal near miss among women in public hospital maternity wards
in Northern, Ethiopia: A facility based case-control study.
Dejene Ermias
BSc,MPHRH, Ethiopia
Background:
In Ethiopia, 20,000 women die each year from complications during pregnancy, childbirth and
the post-partum period. For every woman who dies of pregnancy complications, about 20 more experience
injury, infection, disease, or disability. “Maternal near misses” (MNM),defined by the World Health Organization
(WHO) as a woman who nearly dies, but survives a complication during pregnancy, childbirth or within 42 days
of termination, is a proxy indicator of maternal mortality and quality of obstetric care. In Ethiopia, few studies
have been performed on MNM, and little is known regarding determinant factors. This study aims to identify
determinants of MNM among women in Tigray, Ethiopia.
Methods:
Unmatched case-control study in hospitals in Tigray Region, Northern Ethiopia, from January 30
- March 30, 2016. The sample included 103 cases and 205 controls recruited from women seeking obstetric
care at six public (6) hospitals. Clients having a life-threatening obstetric complication including hemorrhage,
hypertensive diseases of pregnancy, dystocia, infections, and anemia or clinical signs of severe anemia in women
without hemorrhage were taken as cases and those with normal obstetric outcomes were considered as controls.
Cases were selected based on proportional to size allocation while systematic sampling was employed for
controls. Data was analyzed using SPSS version 20.0. Binary and multiple variable logistic regression (“odds
ratio”) analyses were calculated with 95% CI.
Results:
The largest proportion of cases and controls was between the ages of 20–29 years, accounting for 39
(37.9%) of cases and 65(31.7%) of controls. Roughly 90% of cases and controls were married. About two-
thirds of controls and 47(45.6%) of cases had gestational age between 37-41 weeks. History of chronic medical
conditions was reported in 57(55.3 %) of cases and 68(33.2%) of controls. Women with no formal education
[AOR=3.2;95%CI:1.24, 8.12],being less than 16 years old at first pregnancy [AOR=2.5; 95%CI:1.12,5.63],induced
labor[AOR=3; 95%CI:1.44, 6.17],history of Cesarean section(C-section)[AOR=4.6; 95%CI: 1.98, 7.61] or
chronic medical disorder[AOR=3.5;95%CI:1.78, 6.93], and women who traveled more than 60 minutes before
reaching their final place of care[AOR=2.8;95% CI: 1.19,6.35] all had higher odds of experiencing MNM.
Conclusions:
The Government of Ethiopia should continue its effort to address lack of road and health facility
access as well as education, which will help reduce MNM. Work should also be continued to educate women and
providers about common predictors of MNM like history of C-section, chronic illness, and teenage pregnancy.
These efforts should be carried out at the facility, community, and individual levels. Targeted follow-up to women
with history of chronic disease and C-section could also be a practical way to reduce MNM.
dj.ermi2005@gmail.com