A prospective cause of death classification system for maternal deaths in low and middle-income countries: results from the Global Network Maternal Newborn Health Registry.

Autor: Pasha O; Aga Khan University, Karachi, Pakistan.; Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA., McClure EM; RTI International, Durham, NC, USA., Saleem S; Aga Khan University, Karachi, Pakistan., Tikmani SS; Aga Khan University, Karachi, Pakistan., Lokangaka A; Kinshasa School of Public Health, Kinshasa, Democratic Republic of the Congo., Tshefu A; Kinshasa School of Public Health, Kinshasa, Democratic Republic of the Congo., Bose CL; University of North Carolina at Chapel Hill, Chapel Hill, NC, USA., Bauserman M; University of North Carolina at Chapel Hill, Chapel Hill, NC, USA., Mwenechanya M; University Teaching Hospital, Lusaka, Zambia., Chomba E; University Teaching Hospital, Lusaka, Zambia., Carlo WA; University of Alabama at Birmingham, Birmingham, AL, USA., Garces AL; INCAP, Guatemala City, Guatemala., Figueroa L; INCAP, Guatemala City, Guatemala., Hambidge KM; University of Colorado, School of Medicine, Denver, CO, USA., Krebs NF; University of Colorado, School of Medicine, Denver, CO, USA., Goudar S; KLE University's JN Medical College, Belagavi, India., Kodkany BS; KLE University's JN Medical College, Belagavi, India., Dhaded S; KLE University's JN Medical College, Belagavi, India., Derman RJ; Thomas Jefferson University, Philadelphia, PA, USA., Patel A; Lata Medical Research Foundation, Nagpur, India., Hibberd PL; Boston University, Boston, MA, USA., Esamai F; Moi University, Eldoret, Kenya., Tenge C; Moi University, Eldoret, Kenya., Liechty EA; Indiana University, Indianapolis, IN, USA., Moore JL; RTI International, Durham, NC, USA., Wallace DD; RTI International, Durham, NC, USA., Koso-Thomas M; NICHD, Rockville, MD, USA., Miodovnik M; NICHD, Rockville, MD, USA., Goldenberg RL; Columbia University School of Medicine, New York, NY, USA.
Jazyk: angličtina
Zdroj: BJOG : an international journal of obstetrics and gynaecology [BJOG] 2018 Aug; Vol. 125 (9), pp. 1137-1143. Date of Electronic Publication: 2018 May 21.
DOI: 10.1111/1471-0528.15011
Abstrakt: Objective: To describe the causes of maternal death in a population-based cohort in six low- and middle-income countries using a standardised, hierarchical, algorithmic cause of death (COD) methodology.
Design: A population-based, prospective observational study.
Setting: Seven sites in six low- to middle-income countries including the Democratic Republic of the Congo (DRC), Guatemala, India (two sites), Kenya, Pakistan and Zambia.
Population: All deaths among pregnant women resident in the study sites from 2014 to December 2016.
Methods: For women who died, we used a standardised questionnaire to collect clinical data regarding maternal conditions present during pregnancy and delivery. These data were analysed using a computer-based algorithm to assign cause of maternal death based on the International Classification of Disease-Maternal Mortality system (trauma, termination of pregnancy-related, eclampsia, haemorrhage, pregnancy-related infection and medical conditions). We also compared the COD results to healthcare-provider-assigned maternal COD.
Main Outcome Measures: Assigned causes of maternal mortality.
Results: Among 158 205 women, there were 221 maternal deaths. The most common algorithm-assigned maternal COD were obstetric haemorrhage (38.6%), pregnancy-related infection (26.4%) and pre-eclampsia/eclampsia (18.2%). Agreement between algorithm-assigned COD and COD assigned by healthcare providers ranged from 75% for haemorrhage to 25% for medical causes coincident to pregnancy.
Conclusions: The major maternal COD in the Global Network sites were haemorrhage, pregnancy-related infection and pre-eclampsia/eclampsia. This system could allow public health programmes in low- and middle-income countries to generate transparent and comparable data for maternal COD across time or regions.
Tweetable Abstract: An algorithmic system for determining maternal cause of death in low-resource settings is described.
(© 2017 Royal College of Obstetricians and Gynaecologists.)
Databáze: MEDLINE
Externí odkaz: