PREVALENCE OF MATERNAL NEAR-MISS AND MATERNAL MORTALITY, THEIR DISTRIBUTION BY GESTATION AND GRAVIDITY AND CAUSES IN WOMEN WITH LIVE BIRTHS IN DISTRICT PESHAWAR, PAKISTAN

Abstract

Background: Maternal near-miss (MNM) and maternal mortality (MM) are indicators for quality of health care system. The objectives of our study were to determine prevalence of MNM and MM and their distribution by gestation and gravidity and their causes in women with live births population of District Peshawar, Pakistan. Material Methods: This cross-sectional study was conducted at Department of Obstetrics and Gynaecology, Lady Reading Hospital, Peshawar, Pakistan from January 2017 to June 2017. From assumed population of 185,676 pregnant women in District Peshawar, 10% prevalence of MNM, 1.0448% margin of error and 95%CL, sample size was calculated 3,115. All women with live birth were eligible. Presence of MNM and MM, causes of MNM and MM, gestational age and gravidity were six variables. Being nominal, all were analysed by count and ratio or percentage with 80%CI. MNM Ratio was calculated per 1,000 live births and MM Ratio per 100,000 live births. Results: Out of 3,115 women with live births, MNM cases were 494 with MNMR 158.59/1,000 (80%CI 150.19-166.97) and MM cases were 16 with MMR 513.64/100,000 population (95%CI 349.50-677.78). There were 232 MNM cases in ≤28 weeks and 262 in 28 weeks gestational age with similar MNMR between these groups. There were 244 MNM cases in primigravida and 250 in multigravida with similar MNMR between these groups. There were five MM cases in ≤28 weeks and 11 in 28 weeks gestational age with similar MMR between these groups. There were five MM cases in primigravida and 11 in multigravida with similar MMR between these groups as their CIs are overlapping. Haemorrhage was most common cause for MNM in 365 (11.7175%) cases and for MM in 8 (0.2568%) cases. Conclusion: The maternal near-miss ratio (MNMR) and maternal mortality ratio (MMR) are relatively higher in population of District, Peshawar, Pakistan. MNMR and MMR both have similar prevalence in ≤28 weeks and in 28 weeks gestational age groups and also similar in primigravida and in multigravida groups. Haemorrhage (antepartum and postpartum) was most common cause both for maternal near-miss (MNM) and maternal mortality (MM).

Keywords

• maternal near-miss
• maternal mortality
• maternal deaths
• eclampsia
• haemorrhage
• sepsis.