• Larissa Paes Leme Galvão, Fabiano Alvim-Pereira, Caio Menezes Machado de Mendonça, Filipe Emanuel Fonseca Menezes, Kaique Andre do Nascimento Góis, Ruy Farias Ribeiro, and Ricardo Queiroz Gurgel.
• Federal University of Sergipe, Av, Beira Mar, 2016 ap, 402 Bairro 13 de julho, Aracaju, SE 49025-040, Brazil. ricardoqgurgel@gmail.com.
• Bmc Pregnancy Childb. 2014 Jan 1;14:25.

BackgroundThe investigation of severe maternal morbidity (SAMM) and maternal near miss (NM) and associated risk factors is important for the global reduction of maternal mortality. This study investigated the prevalence of SAMM and NM cases and the associated risk factors in two reference maternity hospitals in a capital city in Northeast-Brazil.MethodsA cross-sectional study with a nested case-control component was conducted from June-2011 to May-2012. Case identification was prospective and data collection was performed according to WHO criteria and definitions. Odds ratio with confidence intervals and multivariate analysis were used whenever possible.ResultsThere were 16,243 deliveries, 1,102 SAMM cases, 77 NM cases and 17 maternal deaths. The maternal NM outcome ratio was 5.8 cases/1,000 live births (LB); the total prevalence of SAMM + NM was 72.6 cases/1,000 LB, the maternal near miss: mortality ratio was 4.5cases/1 maternal death (18% of mortality index). Management-based criteria were the most common events for NM (87.1%) and hypertensive disorders for SAMM (67.5%). Higher age, previous abortion and caesarean delivery, the non-adhesion to antenatal care, current caesarean delivery and bad perinatal results were associated with SAMM/NM. In the multivariate analysis, patient's status, previous caesarian and abortion and level of consciousness were significant when analyzed together.ConclusionsSAMM and NM situations were prevalent in the studied population and some risk factors seem to be associated with the event, particularly previous gestational antecedents. Protocols based on SAMM/NM situations can save lives and decrease maternal mortality.

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