Severe maternal morbidity in the microregion of Barbacena, Minas Gerais state, Brazil

Abstract Background Complications during pregnancy, birth, and puerperium add up to the tenth death cause among women, and constitute a public health problem in developing countries. Objective The objective of this study was to identify the factors associated with severe maternal morbidity in the microregion of Barbacena, Minas Gerais state, Brazil from February to August 2014. Methods This is a case-control study where all puerperal women who met at least one criterion of morbidity were selected as case, whereas those who did not present any complications were considered as control. The factors associated with morbidity were analyzed using the logistic regression model at 5% significance level. Results The study assessed 276 women, of which 92 were cases and 184 were controls. In the multivariate analysis of the final logistic regression model, the variables that persisted were past medical history of high blood pressure (OR=20.8; CI 95%: 6.4-67.4), prematurity (OR=7.5; CI 95%: 3.8-14.8), and caesarean section (OR=3.4; CI 95%: 1.69-6.76). Conclusions A strong correlation was found between the variables investigated and the occurrence of adverse events, accentuating the importance of early identification of risk factors for maternal morbidity and establishment of preventive strategies.

摘要
研究背景 妊娠、分娩及产褥期并发症位列女性死亡原因第十位，在发展中国家已成为一项公共卫生问题。
研究目的 本研究旨在明确2014年2月至8月间，巴西米纳斯吉拉斯州巴巴塞纳微区域内与严重孕产妇发病（severe maternal morbidity）相关的危险因素。
研究方法 本研究为病例对照研究（case-control study），将至少符合1项发病判定标准的产褥期妇女纳入病例组，未出现任何并发症者作为对照组。采用显著性水平为5%的logistic回归模型（logistic regression model）分析与发病相关的影响因素。
研究结果 本研究共纳入276名妇女，其中病例组92例，对照组184例。最终logistic回归模型的多因素分析显示，持续具有统计学意义的变量包括：既往高血压病史（优势比（Odds Ratio, OR）=20.8；95%置信区间（Confidence Interval, CI）：6.4~67.4）、早产（OR=7.5；95%CI：3.8~14.8）以及剖宫产（OR=3.4；95%CI：1.69~6.76）。
研究结论 本研究发现所调研的变量与不良妊娠事件的发生存在显著相关性，凸显了早期识别孕产妇发病危险因素并制定预防策略的重要性。