[Determinants of risk factors associated with severe maternal morbidity: application during antenatal consultations].
In order to assess the incidence of severe maternal mortality (SMM) and search for associated determinants of risk factors, a population-based survey of 20,326 pregnant women was conducted in six counties in West Africa (MOMA study). Complete files were available for 19,545 (96.2%) women. The rate of SMM, assessed with an overall indicator, was 6.7% (5.7-6.4). The relationship between SMM and various socio-economic features, gyneco-obstetrical antecedents and characteristics of the current pregnancy was studied. Multivariate analysis identified 10 factors of risk of SMM. Prevalence, adjusted odds-ratio, positive predictive value and adjusted attributable risk were determined for these ten factors. By decreasing order of positive predictive value, these factors were: hemorrhage during pregnancy (51.5%), antecedent cesarean (27.1%), high blood pressure (diastolic pressure 10 (18.9%), systolic pressure 14 (14.6%)), antecedent multiple pregnancy (15.8%), height 150 cm (12.9%), lack of fetal movements (12.6%), history of 3 stillborns (9.3%), age over 35 years (8%), nulliparity (7.3%), presence of disease during the pregnancy (7.1%). These results show the importance of antenatal consultation during which these factors are easily identifiable.
Testa
J
J
DIM, CNHU, 01 BP 476, Cotonou, Bénin. jeanrtesta@hotmail.com
Ouédraogo
C
C
Prual
A
A
De Bernis
L
L
Koné
B
B
D000354:Africa, Western / Q000453:epidemiology; D002585:Cesarean Section / Q000706:statistics & numerical data; D005260:Female; D005313:Fetal Death / Q000453:epidemiology; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D016015:Logistic Models; D008423:Maternal Age; D008428:Maternal Mortality; D008429:Maternal Welfare; D009017:Morbidity; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology; D018566:Pregnancy, High-Risk; D011272:Pregnancy, Multiple; D011295:Prenatal Care; D012307:Risk Factors; D014592:Uterine Hemorrhage / Q000453:epidemiology