title: Maternal morbidity and near miss associated with maternal age: the innovative approach of the 2006 Brazilian demographic health survey.
abstract: OBJECTIVE
  To study the prevalence of potentially life-threatening maternal conditions and near miss in Brazil according to maternal age.
  
  
  METHODS
  A secondary analysis of the 2006 Brazilian demographic health survey database using a validated questionnaire to evaluate maternal morbidity with a focus on age extremes. The study included 5,025 women with at least 1 live birth in the 5-year reference period preceding their interviews. Three age range periods were used: 15-19 years (younger age), 20-34 years (control), and 35-49 years (advanced maternal age). According to a pragmatic definition, any woman reporting eclampsia, hysterectomy, blood transfusion, or admission to the intensive care unit during her pregnancy/childbirth was considered a near-miss case. The associations between age and severe maternal morbidity were further assessed.
  
  
  RESULTS
  For the 6,833 reported pregnancies, 73.7% of the women were 20-34 years old, 17.9% were of advanced maternal age, and only 8.4% were of younger age. More than 22% of the women had at least one of the complications appraised, and blood transfusion, which was more prevalent among the controls, was the only variable with a significant difference among the age groups. The overall rate of maternal near miss was 21.1 per 1000 live births. There was a trend of higher maternal near miss with increasing age. The only significant risk factor identified for maternal near miss was a lower literacy level among older women.
  
  
  CONCLUSIONS
  There is a trend towards worse results with increasing age. The investigation of the determinants of maternal near miss at the community level using an innovative approach through a demographic health survey is an example suggested for under-resourced settings.
authors.affiliation: Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas, Campinas, SP, Brazil.
authors.forename: Fernando César de
authors.initials: FC
authors.lastname: Oliveira
authors.forename: Maria Laura
authors.initials: ML
authors.lastname: Costa
authors.forename: Jose Guilherme
authors.initials: JG
authors.lastname: Cecatti
authors.forename: João Luiz
authors.initials: JL
authors.lastname: Pinto e Silva
authors.forename: Fernanda Garanhani
authors.initials: FG
authors.lastname: Surita
mesh_terms: D000293:Adolescent; D000328:Adult; D001938:Brazil / Q000453:epidemiology; D005260:Female; D005865:Gestational Age; D006306:Health Surveys; D006801:Humans; D008423:Maternal Age; D008428:Maternal Mortality; D008875:Middle Aged; D009017:Morbidity; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D011256:Pregnancy Outcome / Q000453:epidemiology; D012307:Risk Factors; D012959:Socioeconomic Factors; D055815:Young Adult
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