Cargando…
Provision of intensive care to severely ill pregnant women is associated with reduced mortality: Results from the WHO Multicountry Survey on Maternal and Newborn Health
OBJECTIVE: To estimate the impact of the use of Intensive Care Units (ICU) in maternal mortality. METHODS: A secondary analysis of the WHO Multicountry Survey on Maternal and Newborn Health, a multicenter cross‐sectional study conducted in maternity hospitals in 29 countries. Women who had severe ma...
Autores principales: | , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2020
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7496974/ https://www.ncbi.nlm.nih.gov/pubmed/32464683 http://dx.doi.org/10.1002/ijgo.13241 |
_version_ | 1783583216789094400 |
---|---|
author | Soares, Fabiano M. Pacagnella, Rodolfo C. Tunçalp, Özge Cecatti, José G. Vogel, Joshua P. Togoobaatar, Ganchimeg Souza, Joao P. |
author_facet | Soares, Fabiano M. Pacagnella, Rodolfo C. Tunçalp, Özge Cecatti, José G. Vogel, Joshua P. Togoobaatar, Ganchimeg Souza, Joao P. |
author_sort | Soares, Fabiano M. |
collection | PubMed |
description | OBJECTIVE: To estimate the impact of the use of Intensive Care Units (ICU) in maternal mortality. METHODS: A secondary analysis of the WHO Multicountry Survey on Maternal and Newborn Health, a multicenter cross‐sectional study conducted in maternity hospitals in 29 countries. Women who had severe maternal outcome (maternal death or maternal near‐miss) and the availability and use of ICU beds were included. The women were categorized according to availability of ICU, and multivariate logistic regression analyses were performed to determine the risk of maternal death. To rate the severity of complications, the Maternal Severity Score (MSS) and the Maternal Severity Index (MSI) were used. RESULTS: Of 314 623 women observed, 24 396 had severe complications. Of those, 16 981 (69.6%) were in facilities with ICUs; 1573 women were admitted to ICUs (6.4% of women with maternal complications and 0.5% of total). There is a significant protective effect for maternal mortality for patients with more severe conditions using ICUs (odds ratio 0.16, 95% confidence interval 0.07–0.33). CONCLUSION: The use of ICU was associated with significantly reduced odds of maternal death in obstetric patients with severe clinical conditions. The availability and appropriate use of good‐quality ICUs are therefore crucial to reduce maternal mortality. |
format | Online Article Text |
id | pubmed-7496974 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-74969742020-09-25 Provision of intensive care to severely ill pregnant women is associated with reduced mortality: Results from the WHO Multicountry Survey on Maternal and Newborn Health Soares, Fabiano M. Pacagnella, Rodolfo C. Tunçalp, Özge Cecatti, José G. Vogel, Joshua P. Togoobaatar, Ganchimeg Souza, Joao P. Int J Gynaecol Obstet Clinical Articles OBJECTIVE: To estimate the impact of the use of Intensive Care Units (ICU) in maternal mortality. METHODS: A secondary analysis of the WHO Multicountry Survey on Maternal and Newborn Health, a multicenter cross‐sectional study conducted in maternity hospitals in 29 countries. Women who had severe maternal outcome (maternal death or maternal near‐miss) and the availability and use of ICU beds were included. The women were categorized according to availability of ICU, and multivariate logistic regression analyses were performed to determine the risk of maternal death. To rate the severity of complications, the Maternal Severity Score (MSS) and the Maternal Severity Index (MSI) were used. RESULTS: Of 314 623 women observed, 24 396 had severe complications. Of those, 16 981 (69.6%) were in facilities with ICUs; 1573 women were admitted to ICUs (6.4% of women with maternal complications and 0.5% of total). There is a significant protective effect for maternal mortality for patients with more severe conditions using ICUs (odds ratio 0.16, 95% confidence interval 0.07–0.33). CONCLUSION: The use of ICU was associated with significantly reduced odds of maternal death in obstetric patients with severe clinical conditions. The availability and appropriate use of good‐quality ICUs are therefore crucial to reduce maternal mortality. John Wiley and Sons Inc. 2020-07-12 2020-09 /pmc/articles/PMC7496974/ /pubmed/32464683 http://dx.doi.org/10.1002/ijgo.13241 Text en © 2020 The Authors. International Journal of Gynecology & Obstetrics published by John Wiley & Sons Ltd on behalf of International Federation of Gynecology and Obstetrics This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Clinical Articles Soares, Fabiano M. Pacagnella, Rodolfo C. Tunçalp, Özge Cecatti, José G. Vogel, Joshua P. Togoobaatar, Ganchimeg Souza, Joao P. Provision of intensive care to severely ill pregnant women is associated with reduced mortality: Results from the WHO Multicountry Survey on Maternal and Newborn Health |
title | Provision of intensive care to severely ill pregnant women is associated with reduced mortality: Results from the WHO Multicountry Survey on Maternal and Newborn Health |
title_full | Provision of intensive care to severely ill pregnant women is associated with reduced mortality: Results from the WHO Multicountry Survey on Maternal and Newborn Health |
title_fullStr | Provision of intensive care to severely ill pregnant women is associated with reduced mortality: Results from the WHO Multicountry Survey on Maternal and Newborn Health |
title_full_unstemmed | Provision of intensive care to severely ill pregnant women is associated with reduced mortality: Results from the WHO Multicountry Survey on Maternal and Newborn Health |
title_short | Provision of intensive care to severely ill pregnant women is associated with reduced mortality: Results from the WHO Multicountry Survey on Maternal and Newborn Health |
title_sort | provision of intensive care to severely ill pregnant women is associated with reduced mortality: results from the who multicountry survey on maternal and newborn health |
topic | Clinical Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7496974/ https://www.ncbi.nlm.nih.gov/pubmed/32464683 http://dx.doi.org/10.1002/ijgo.13241 |
work_keys_str_mv | AT soaresfabianom provisionofintensivecaretoseverelyillpregnantwomenisassociatedwithreducedmortalityresultsfromthewhomulticountrysurveyonmaternalandnewbornhealth AT pacagnellarodolfoc provisionofintensivecaretoseverelyillpregnantwomenisassociatedwithreducedmortalityresultsfromthewhomulticountrysurveyonmaternalandnewbornhealth AT tuncalpozge provisionofintensivecaretoseverelyillpregnantwomenisassociatedwithreducedmortalityresultsfromthewhomulticountrysurveyonmaternalandnewbornhealth AT cecattijoseg provisionofintensivecaretoseverelyillpregnantwomenisassociatedwithreducedmortalityresultsfromthewhomulticountrysurveyonmaternalandnewbornhealth AT vogeljoshuap provisionofintensivecaretoseverelyillpregnantwomenisassociatedwithreducedmortalityresultsfromthewhomulticountrysurveyonmaternalandnewbornhealth AT togoobaatarganchimeg provisionofintensivecaretoseverelyillpregnantwomenisassociatedwithreducedmortalityresultsfromthewhomulticountrysurveyonmaternalandnewbornhealth AT souzajoaop provisionofintensivecaretoseverelyillpregnantwomenisassociatedwithreducedmortalityresultsfromthewhomulticountrysurveyonmaternalandnewbornhealth |