title: Subsequent reproductive outcome in women who have experienced a potentially life-threatening condition or a maternal near-miss during pregnancy.
abstract: OBJECTIVE
  To evaluate the long-term reproductive consequences that affect women who have experienced potentially life-threatening or life-threatening (near-miss) maternal complications.
  
  
  BACKGROUND
  Although advances have been made in reducing maternal death, few studies have investigated the long-term repercussions of significant events such as severe maternal morbidity and maternal near-misses. These repercussions may be long-lasting and negatively affect quality of life.
  
  
  METHODS
  A total of 382 women who had experienced a potentially life-threatening pregnancy-related condition within the last five years were analyzed in this retrospective cohort study. A control group of 188 women who gave birth without complications was also included. Trained interviewers contacted the subjects by telephone and completed a pre-coded, structured questionnaire on reproductive health. Data were analyzed using odds ratios adjusted for age. The main outcome measures were occurrence and outcome of subsequent pregnancies.
  
  
  RESULTS
  The estimated risk of becoming infertile as a result of tubal ligation or hysterectomy was 3.5 times higher in women who experienced a maternal near-miss or severe maternal morbidity during the index pregnancy as compared to controls. Likewise, the risk of complications in subsequent pregnancies was five times greater in women who had experienced severe maternal morbidity. However, no differences were found in the occurrence or number of subsequent pregnancies or perinatal outcome.
  
  
  CONCLUSIONS
  The occurrence of a life-threatening or potentially life-threatening maternal condition reduces future reproductive potential and increases the risk of complications in subsequent pregnancies.
authors.affiliation: Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas, Campinas, SP, Brazil.
authors.forename: Rodrigo S
authors.initials: RS
authors.lastname: Camargo
authors.forename: Rodolfo C
authors.initials: RC
authors.lastname: Pacagnella
authors.forename: José G
authors.initials: JG
authors.lastname: Cecatti
authors.forename: Mary A
authors.initials: MA
authors.lastname: Parpinelli
authors.forename: João P
authors.initials: JP
authors.lastname: Souza
authors.forename: Maria H
authors.initials: MH
authors.lastname: Sousa
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D015331:Cohort Studies; D004522:Educational Status; D005260:Female; D006801:Humans; D011247:Pregnancy; D011248:Pregnancy Complications / Q000401:mortality / Q000523:psychology*; D011256:Pregnancy Outcome / Q000523:psychology*; D011788:Quality of Life / Q000523:psychology*; D012189:Retrospective Studies; D055815:Young Adult