• Rev Assoc Med Bras (1992) · Jan 2023

    Maternal near miss: before and during the coronavirus disease 2019 pandemic.

    • Cijara Leonice de Freitas, Ayane Cristine Sarmento, MedeirosKleyton Santos deKS0000-0002-4105-7535Universidade Federal do Rio Grande Do Norte, Health Sciences Center - Natal (RN), Brazil., Maria Emanuela Matos Leonardo, Ythalo Hugo da Silva Santos, and Ana Katherine Gonçalves.
    • Universidade Federal do Rio Grande Do Norte, Health Sciences Center - Natal (RN), Brazil.
    • Rev Assoc Med Bras (1992). 2023 Jan 1; 69 (10): e20230048e20230048.

    ObjectiveThe aim of this study was to evaluate and compare Maternal Near Miss prevalence and outcomes before and during the coronavirus disease 2019 pandemic.MethodsThis retrospective study was carried out in a university maternity hospital of high complexity. The population was divided into two groups: G1, 1 year before the coronavirus disease 2019 pandemic period (August 2018-July 2019) and G2, 1 year during the pandemic period (August 2020-July 2021). All pregnant/postpartum women hospitalized up to 42 days after the end of pregnancy/childbirth were included, and pregnant women who were admitted with coronavirus disease 2019/flu symptoms were excluded. The association of variables with "Maternal Near Miss" was estimated using logistic regression.ResultsA total of 568 women from G1 and 349 women from G2 fulfilled the Maternal Near Miss criteria. The prevalence of Maternal Near Miss in pre-pandemic was 144.1/1,000 live births and during the pandemic was 78.5/1,000 live births. In the analysis adjusted for G1, the factors of days of hospitalization (PR: 1.02, CI: 1.0-1.0, p<0.05), pre-eclampsia (PR: 0.41, CI: 1.4-2.2, p<0.05), and sepsis/severe systemic infection (PR: 1.79, CI: 0.3-0.4, p<0.05) were crucial for women with the Maternal Near Miss condition to have a greater chance of being admitted to the intensive care unit. In G2, low education (PR: 0.45, CI: 0.2-0.9, p<0.05), eclampsia (PR: 5.28, CI: 3.6-7.6, p<0.05), and use of blood products (PR: 6.48, CI: 4.7-8.8, p<0.05) increased the risk of admission to the intensive care unit.ConclusionDuring the pandemic, there was a lower prevalence of Maternal Near Miss in high-risk pregnancies, fewer hospitalizations, and more deaths compared to the non-pandemic period.

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