Jing Tan1,2, Xing-Hui Liu3, Chuan Yu1, Meng Chen3, Xiao-Fan Chen1, Xin Sun1, You-Ping Li1. 1. Chinese Evidence-based Medicine Center, West China Hospital, Sichuan University, Chengdu, China. 2. Chengdu University of Traditional Chinese Medicine, Chengdu, China. 3. West China Women's and Children's Hospital, Sichuan University, Chengdu, China.
Abstract
OBJECTIVE: To investigate the incidence of severe maternal morbidities (SMM) in China and explore effects of medical co-morbidities on SMM. DESIGN: Proactive multicenter clinic register collaboration. SETTING: Data on all deliveries at eight hospitals in Sichuan province, China, collected from 1 January 2009 to 12 December 2010. POPULATION: 33 993 delivering women and 34 547 live births. METHODS: We defined SMM as a combination indicator of severe maternal complications, critical interventions, admission to the intensive care unit and maternal near-miss instances. We randomly selected 80% of the data from the entire database to build a logistic regression model. The remaining 20% were used to test the predictive power of the model. MAIN OUTCOME MEASURES: SMM incidence, adjusted odds ratios (aORs), and area under a receiver operating characteristic (ROC) curve. RESULTS: Severe maternal morbidities incidence was 43.4/1000 live births [confidence interval (CI) 41.24-45.56]. Fifteen variables were independent contributors to the model. Seven medical co-morbidities significantly affected the occurrence of SMM, including iron-deficiency anemia (aOR 3.07, CI 2.47-3.83) and other hematological diseases (aOR 5.82, CI 3.50-9.69), hepatitis-B virus infection (aOR 1.48, CI 1.12-1.97) and other hepatic diseases (aOR 3.81, CI 1.61-9.04), cardiopathy (aOR 3.59, CI 2.62-4.93), hypertension (aOR 5.23, CI 4.06-6.75), and respiratory diseases (aOR 2.10, CI 1.25-3.52). The area under the ROC curve was 0.8127. CONCLUSIONS: The incidence of SMM was typical of a low resource area. There is a need to identify medical co-morbidities and to adopt prophylactic measures and interventions.
OBJECTIVE: To investigate the incidence of severe maternal morbidities (SMM) in China and explore effects of medical co-morbidities on SMM. DESIGN: Proactive multicenter clinic register collaboration. SETTING: Data on all deliveries at eight hospitals in Sichuan province, China, collected from 1 January 2009 to 12 December 2010. POPULATION: 33 993 delivering women and 34 547 live births. METHODS: We defined SMM as a combination indicator of severe maternal complications, critical interventions, admission to the intensive care unit and maternal near-miss instances. We randomly selected 80% of the data from the entire database to build a logistic regression model. The remaining 20% were used to test the predictive power of the model. MAIN OUTCOME MEASURES: SMM incidence, adjusted odds ratios (aORs), and area under a receiver operating characteristic (ROC) curve. RESULTS: Severe maternal morbidities incidence was 43.4/1000 live births [confidence interval (CI) 41.24-45.56]. Fifteen variables were independent contributors to the model. Seven medical co-morbidities significantly affected the occurrence of SMM, including iron-deficiency anemia (aOR 3.07, CI 2.47-3.83) and other hematological diseases (aOR 5.82, CI 3.50-9.69), hepatitis-B virus infection (aOR 1.48, CI 1.12-1.97) and other hepatic diseases (aOR 3.81, CI 1.61-9.04), cardiopathy (aOR 3.59, CI 2.62-4.93), hypertension (aOR 5.23, CI 4.06-6.75), and respiratory diseases (aOR 2.10, CI 1.25-3.52). The area under the ROC curve was 0.8127. CONCLUSIONS: The incidence of SMM was typical of a low resource area. There is a need to identify medical co-morbidities and to adopt prophylactic measures and interventions.
Authors: Stacie E Geller; Abigail R Koch; Caitlin E Garland; E Jane MacDonald; Francesca Storey; Beverley Lawton Journal: Reprod Health Date: 2018-06-22 Impact factor: 3.223