title: Effects of severe obstetric complications on women's health and infant mortality in Benin.
abstract: OBJECTIVE
  To document the impact of severe obstetric complications on post-partum health in mothers and mortality in babies over 12 months in Benin and to assess whether severe complications associated with perinatal death are particularly likely to lead to adverse health consequences.
  
  
  METHODS
  Cohort study which followed women and their babies after a severe complication or an uncomplicated childbirth. Women were selected in hospitals and interviewed at home at discharge, and at 6 and 12 months post-partum. Women were invited for a medical check-up at 6 months and 12 months.
  
  
  RESULTS
  The cohort includes 205 women with severe complications and a live birth, 64 women with severe complications and perinatal death and 440 women with uncomplicated delivery. Women with severe complications and a live birth were not dissimilar to women with a normal delivery in terms of post-partum health, except for hypertension [adjusted OR = 5.8 (1.9-17.0)], fever [adjusted OR = 1.71 (1.1-2.8)] and infant mortality [adjusted OR = 11.0 (0.8-158.2)]. Women with complications and perinatal death were at increased risk of depression [adjusted OR = 3.4 (1.3-9.0)], urine leakages [adjusted OR = 2.7 (1.2-5.8)], and to report poor health [adjusted OR = 5.27 (2.2-12.4)] and pregnancy's negative effects on their life [adjusted OR = 4.11 (1.9-9.0)]. Uptake of post-natal services was poor in all groups.
  
  
  CONCLUSIONS
  Women in developing countries face a high risk of severe complications during pregnancy and delivery. These can lead to adverse consequences for their own health and that of their offspring. Resources are needed to ensure that pregnant women receive adequate care before, during and after discharge from hospital. Near-miss women with a perinatal death appear a particularly high-risk group.
authors.affiliation: Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.
authors.forename: Véronique
authors.initials: V
authors.lastname: Filippi
authors.forename: Sourou
authors.initials: S
authors.lastname: Goufodji
authors.forename: Charalambos
authors.initials: C
authors.lastname: Sismanidis
authors.forename: Lydie
authors.initials: L
authors.lastname: Kanhonou
authors.forename: Edward
authors.initials: E
authors.lastname: Fottrell
authors.forename: Carine
authors.initials: C
authors.lastname: Ronsmans
authors.forename: Eusèbe
authors.initials: E
authors.lastname: Alihonou
authors.forename: Vikram
authors.initials: V
authors.lastname: Patel
mesh_terms: D000328:Adult; D001541:Benin / Q000453:epidemiology; D015331:Cohort Studies; D019052:Depression, Postpartum / Q000453:epidemiology; D005260:Female; D006304:Health Status; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D007223:Infant; D007226:Infant Mortality; D007744:Obstetric Labor Complications / Q000401:mortality; D016017:Odds Ratio; D011181:Postnatal Care / Q000706:statistics & numerical data; D011247:Pregnancy; D016387:Women's Health
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