• Wei-Hong Zhang, Sophie Alexander, Marie-Hélène Bouvier-Colle, Alison Macfarlane, and MOMS-B Group.
• Unité de recherche en Santé Reproductive et Epidémiologie Périnatale, Département des Politiques et Systémes de Santé, Ecole de Santé Publique, Université Libre de Bruxelles, Brussels, Belgium.
• BJOG. 2005 Jan 1; 112 (1): 89-96.

ObjectiveTo describe the incidence of three conditions of acute severe maternal morbidity in selected regions in nine European countries.DesignA population-based questionnaire survey.SettingEleven regions in nine countries of Europe.PopulationAll the pregnant women in each region who had delivered during the period covered by the study.MethodsStandard definitions of three severe obstetric conditions, pre-eclampsia, postpartum haemorrhage and sepsis were established by a steering committee. A common questionnaire was used in each participating country. The incidence of the three obstetric conditions and characteristics of the study women were compared.Main Outcome MeasuresIncidence of three severe obstetric conditions: pre-eclampsia, postpartum haemorrhage and sepsis.ResultsThe study identified 1734 women with at least one of the three conditions, with 847 experiencing severe haemorrhage, 793 experiencing severe pre-eclampsia and 142 experiencing severe sepsis. There were wide variations in incidence of three conditions combined, ranging from 14.7 per thousand deliveries in Brussels, Belgium to 6.0 per thousand deliveries in Upper Austria.ConclusionsThis study sets a simple and straightforward approach to the definition of three severe obstetric conditions and allows population-based comparisons between developed countries in Europe, even though difficulties may have been present with applying the definition across countries. The reported incidence of these severe obstetric conditions in general and severe haemorrhage varied significantly between countries. Overall, severe haemorrhage in particular was the most common of the three conditions, followed closely by severe pre-eclampsia.

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