title: Severe maternal morbidity due to abortion prospectively identified in a surveillance network in Brazil.
abstract: OBJECTIVE
  To evaluate the occurrence of severe maternal complications associated with abortion in Brazil.
  
  
  METHODS
  In a cross-sectional multicenter study, prospective surveillance was done for cases of potentially life-threatening conditions (PLTC), maternal near miss (MNM), and maternal death (MD) among 9555 women with obstetric complications between June 2009 and May 2010. Abortion was evaluated as a cause, and sociodemographic and obstetric characteristics, safety conditions where the abortion was performed, and the medical procedures used were also assessed. Prevalence ratios adjusted for the cluster effect of the design were calculated with 95% confidence intervals. Multiple logistic regression analysis was performed to identify factors independently associated with greater severity.
  
  
  RESULTS
  For 237 women (2.5%), abortion resulted in severe complications including PLTC (81.9%), MNM (15.2%), and MD (3%). When abortion was unsafe, infectious causes were more common for PLTC, whereas management criteria were more important for MNM and MD. In multivariate analysis, the presence of previous maternal conditions (sickle cell disease, low weight, neoplasm), being transferred or referred, previous uterine scar, and delays were associated with greater severity.
  
  
  CONCLUSIONS
  Abortion was responsible for only a small percentage of the complications associated with pregnancy; however, the risk of abortion-related complications progressing unfavorably was higher.
authors: Department of Obstetrics and Gynecology, University of Campinas, Campinas, Brazil.
authors: Danielly S
authors: DS
authors: Santana
authors: José G
authors: JG
authors: Cecatti
authors: Mary A
authors: MA
authors: Parpinelli
authors: Samira M
authors: SM
authors: Haddad
authors: Maria L
authors: ML
authors: Costa
authors: Maria H
authors: MH
authors: Sousa
authors: João P
authors: JP
authors: Souza
authors: Rodrigo S
authors: RS
authors: Camargo
authors: Rodolfo C
authors: RC
authors: Pacagnella
authors: Fernanda G
authors: FG
authors: Surita
authors: João L
authors: JL
authors: Pinto E Silva
mesh_terms: D000028:Abortion, Induced / Q000009:adverse effects* / Q000706:statistics & numerical data; D000293:Adolescent; D000328:Adult; D001938:Brazil / Q000453:epidemiology; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D015994:Incidence; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology* / Q000209:etiology; D015995:Prevalence; D011446:Prospective Studies; D062486:Public Health Surveillance; D012720:Severity of Illness Index; D055815:Young Adult