Quality and outcomes of maternal and perinatal care for 76,563 pregnancies reported in a nationwide network of Nigerian referral-level hospitals.

Autor:	Tukur J; Department of Obstetrics and Gynaecology, Aminu Kano Teaching Hospital, Kano, Nigeria., Lavin T; UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland., Adanikin A; UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland., Abdussalam M; Department of Paediatrics, Aminu Kano Teaching Hospital, Kano, Nigeria., Bankole K; Department of Paediatrics, Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Nigeria., Ekott MI; Department of Obstetrics and Gynaecology, University of Calabar Teaching Hospital, Calabar, Nigeria., Godwin A; Department of Obstetrics and Gynaecology, University of Abuja Teaching Hospital, Gwagwalada, Nigeria., Ibrahim HA; Department of Paediatrics, University of Maiduguri Teaching Hospital, Maiduguri, Nigeria., Ikechukwu O; Department of Paediatrics, University of Benin Teaching Hospital, Benin City, Nigeria., Kadas SA; Department of Obstetrics and Gynaecology, Abubakar Tafawa Balewa University Teaching Hospital, Bauchi, Nigeria., Nwokeji-Onwe L; Department of Paediatrics, Alex Ekwueme Federal University Teaching Hospital, Federal Teaching, Abakaliki, Nigeria., Nzeribe E; Department of Obstetrics and Gynaecology, Federal Medical Centre, Owerri, Nigeria., Ogunkunle TO; Department of Paediatrics, Dalhatu Arab Specialist Hospital, Lafia, Nigeria., Oyeneyin L; Department of Obstetrics and Gynaecology, University of Medical Science Teaching Hospital, Ondo, Nigeria., Tunau KA; Department of Obstetrics and Gynaecology, Usman Dan Fodiyo University Teaching Hospital, Sokoto, Nigeria., Bello M; Department of Community Medicine, Aminu Kano Teaching Hospital, Kano, Nigeria., Aminu I; Data Analysis Unit, National Coordinating Secretariat, Maternal and Perinatal Database for Quality, Equity, and Dignity Programme, AKTH, Kano, Nigeria., Ezekwe B; Department of Ageing and Life Course, World Health Organization, Nigeria Country Office, Abuja, Nigeria., Aboyeji P; Department of Obstetrics and Gynaecology, University of Ilorin Teaching Hospital, Ilorin, Nigeria., Adesina OA; Department of Obstetrics and Gynaecology, University College Hospital, Ibadan, Nigeria., Chama C; Department of Obstetrics and Gynaecology, Abubakar Tafawa Balewa University Teaching Hospital, Bauchi, Nigeria., Etuk S; Department of Obstetrics and Gynaecology, University of Calabar Teaching Hospital, Calabar, Nigeria., Galadanci H; African Center of Excellence for Population Health and Policy, Bayero University Kano, Nigeria., Ikechebelu J; Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria., Oladapo OT; UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland.
Jazyk:	angličtina
Zdroj:	EClinicalMedicine [EClinicalMedicine] 2022 Apr 28; Vol. 47, pp. 101411. Date of Electronic Publication: 2022 Apr 28 (Print Publication: 2022).
DOI:	10.1016/j.eclinm.2022.101411
Abstrakt:	Background: The WHO in collaboration with the Nigeria Federal Ministry of Health, established a nationwide electronic data platform across referral-level hospitals. We report the burden of maternal, foetal and neonatal complications and quality and outcomes of care during the first year. Methods: Data were analysed from 76,563 women who were admitted for delivery or on account of complications within 42 days of delivery or termination of pregnancy from September 2019 to August 2020 across the 54 hospitals included in the Maternal and Perinatal Database for Quality, Equity and Dignity programme. Findings: Participating hospitals reported 69,055 live births, 4,498 stillbirths and 1,090 early neonatal deaths. 44,614 women (58·3%) had at least one pregnancy complication, out of which 6,618 women (8·6%) met our criteria for potentially life-threatening complications, and 940 women (1·2%) died. Leading causes of maternal death were eclampsia ( n  = 187,20·6%), postpartum haemorrhage (PPH) ( n  = 103,11·4%), and sepsis ( n  = 99,10·8%). Antepartum hypoxia ( n  = 1455,31·1%) and acute intrapartum events ( n  = 913,19·6%) were the leading causes of perinatal death. Predictors of maternal and perinatal death were similar: low maternal education, lack of antenatal care, referral from other facility, previous caesarean section, latent-phase labour admission, operative vaginal birth, non-use of a labour monitoring tool, no labour companion, and non-use of uterotonic for PPH prevention. Interpretation: This nationwide programme for routine data aggregation shows that maternal and perinatal mortality reduction strategies in Nigeria require a multisectoral approach. Several lives could be saved in the short term by addressing key predictors of death, including gaps in the coverage of internationally recommended interventions such as companionship in labour and use of labour monitoring tool. Funding: This work was funded by MSD for Mothers; and UNDP/UNFPA/ UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), a co-sponsored programme executed by the World Health Organization (WHO). Competing Interests: The authors declare no competing interests. (© 2022 World Health Organization.)
Databáze:	MEDLINE
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