Prevalence and Predictive Factors for the Development of Maternal Near Miss. A Retrospective Analysis.

Abstract

Introduction: Maternal mortality is a critical indicator to assess the quality of health services. Analysis of pregnant women with severe maternal outcome (SMO), comprising of maternal near miss (MNM) and maternal death (MD), are likely to identify factors associated with it and help us to take corrective measures to reduce severe maternal outcome. Information on MNM in Bihar is inadequate.

Objectives: To estimate prevalence of MNM cases and to determine contributory and predictive factors responsible for the occurrence of MNM.

Material and methods: All the patients admitted in the labour room during the study period from July 2021 to December 2023 were included. Near-miss cases were noted based on the WHO near‑miss criteria on identifying a) Severe maternal complications b) Critical interventions or intensive care unit use and c) Life-threatening organ dysfunction.

Result: The MNM incidence ratio was 80.06/1000 live births, the MNM to mortality ratio was 3.1:1, and the mortality index was 17.33%. Pre-eclampsia and eclampsia were the most common causes of near-miss events 21 (18.4%) and sepsis was the most common cause 21(58.3%) responsible for maternal death. Presence of acute kidney injury, sepsis and blood transfusions were found to be significantly correlated with maternal death.

Conclusion: MNM is an important indicator to assess the quality of health services. Timely recognition and appropriate intervention of this condition is important to prevent maternal death.