Data from: Determinants of maternal near misses in Morocco: too late, too far, too sloppy?|孕产妇健康数据集|医疗保健数据集

Background: In Morocco, there is little information on the circumstances
surrounding maternal near misses. This study aimed to determine the
incidence, characteristics, and determinants of maternal near misses in
Morocco. Method:A prospective case-control study was conducted at 3
referral maternity hospitals in the Marrakech region of Morocco between
February and July 2012. Near-miss cases included severe hemorrhage,
hypertensive disorders, and prolonged obstructed labor. Three unmatched
controls were selected for each near-miss case. Three categories of risk
factors (sociodemographics, reproductive history, and delays), as well as
perinatal outcomes, were assessed, and bivariate and multivariate analyses
of the determinants were performed. A sample of 30 near misses and 30
non-near misses was interviewed. Results:The incidence of near misses was
12‰ of births. Hypertensive disorders during pregnancy (45%) and severe
hemorrhage (39%) were the most frequent direct causes of near miss. The
main risk factors were illiteracy [OR = 2.35; 95% CI: (1.07–5.15)], lack
of antenatal care [OR = 3.97; 95% CI: (1.42–11.09)], complications during
pregnancy [OR = 2.81; 95% CI:(1.26–6.29)], and having experienced a first
phase delay [OR = 8.71; 95% CI: (3.97–19.12)] and a first phase of third
delay [OR = 4.03; 95% CI: (1.75–9.25)]. The main reasons for the first
delay were lack of a family authority figure who could make a decision,
lack of sufficient financial resources, lack of a vehicle, and fear of
health facilities. The majority of near misses demonstrated a third delay
with many referrals. The women’s perceptions of the quality of their care
highlighted the importance of information, good communication, and
attitude. Conclusion:Women and newborns with serious obstetric
complications have a greater chance of successful outcomes if they are
immediately directed to a functioning referral hospital and if the
providers are responsive.