| dc.description.abstract |
Objective: To compare the immediate perinatal outcome of females with maternal
near-miss (MNM) morbidity and those without near-miss morbidity in Moi Teaching
and Referral Hospital (MTRH), Eldoret, Kenya.
Methods: A case-control study was conducted at MTRH. Near-miss cases
were identified using World Health Organization (WHO) criteria for near-miss. A
consecutive sampling technique was applied to obtain a total of 45 cases and 225
controls. Determinants of near-miss were assessed using a binary logistic regression
model. Perinatal outcomes were compared between the near-miss and control.
Results: Severe maternal outcome ratio was 11.4 per 1,000 live births, the MNM
ratio was 10.4 per 1,000 live births (95% confidence interval [CI]:7.6–13.9), and MNM
mortality ratio was 11.2. The most common condition associated with near-miss was
haematological or coagulation dysfunction (64%). Hypertension was the leading
underlying cause of near-miss (35%). Factors associated with reduced odds of
near-miss were employment (odds ratio: 0.12; 95% CI: 0.03–0.42) and awareness
of danger signs (odds ratio: 0.41; 95% CI: 0.19–0.91). Most babies of the near-miss
cases were born alive (76%), with median appearance, pulse, grimace, activity,
respiration (Apgar) score of 9/10; stillbirth rate was 22%; and median birth weight
was 2,700 g. This was similar to the control group with live birth at 77%, a median
Apgar score of 9/10, and stillbirth of 23%. There was no statistically significant
difference in perinatal outcome between cases and control.
Conclusion: MNM indicators are comparable to the world. The determinants of
near-miss are unemployment and lack of awareness of danger signs. There was no
difference in perinatal outcome between the cases and control. |
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