[Severe maternal morbidity at a local reference university hospital in Campinas, São Paulo, Brazil].
OBJECTIVE
to assess the prevalence and risk factors associated with near miss and other severe maternal morbidity at a reference tertiary maternity.


METHODS
this is a cross-sectional study on severe maternal morbidity at the Hospital e Maternidade Celso Pierro, Campinas, São Paulo, between October 2005 and July 2006, identified from infirmary, admission and delivery unit logbooks. Pregnant and post-partum women with severe maternal morbidity were identified according to clinical criteria proposed by Waterstone. Later, cases with more severe morbidity, called extremely severe maternal morbidity, were reclassified using Mantel criteria, based on organic dysfunction and clinical management.


RESULTS
there were 114 severe maternal morbidity cases among 2,207 birth deliveries, with a ratio of other severe morbidity and extremely severe morbidity near miss of 44.9 and 6.8 cases/1,000 live births, respectively. Mean gestational age at delivery was 35 weeks, and 87% came from the reference area for the maternity service. Hypertension (severe pre-eclampsia) represented 96% of other severe morbidity, while hemorrhage represented 60% of all extremely severe cases, followed by hypertension. The prevalence of extremely severe morbidity among the severe morbidity cases was not associated with marital status, schooling, maternal age, type of delivery, parity, gestational age at birth and home place.


CONCLUSIONS
the other morbidities were 6.6 times more frequent than near miss, and it was not possible to differentiate both groups by epidemiological risk factors.
Luz
Adriana Gomes
AG
Departamento de Tocoginecologia, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brazil. adrigoluz@terra.com.br
Tiago
Douglas Bernal
DB
Silva
José Carlos Gama da
JC
Amaral
Eliana
E
D000328:Adult; D001938:Brazil; D003430:Cross-Sectional Studies; D005260:Female; D006785:Hospitals, University; D006801:Humans; D011247:Pregnancy; D011248:Pregnancy Complications / Q000145:classification / Q000175:diagnosis* / Q000453:epidemiology*; D015995:Prevalence; D012017:Referral and Consultation; D012307:Risk Factors; D012720:Severity of Illness Index; D014505:Urban Population; D055815:Young Adult