Comorbidities and lack of blood transfusion may negatively affect maternal outcomes of women with obstetric hemorrhage treated with NASG.
The Non-Pneumatic Anti-Shock Garment (NASG) is a first-aid device to reduce mortality from severe obstetric hemorrhage, the leading cause of maternal mortality globally. We sought to evaluate patient characteristics associated with mortality among a cohort of women treated with the NASG in Nigeria. Data on 1,149 women were collected from 50 facilities participating in the Pathfinder International Continuum of Care: Addressing Postpartum Hemorrhage project in Nigeria from 2007-2012. Characteristics were compared using the appropriate distributional tests, and we estimated multivariable logistic regression models to control for treatment received. There were 201 deaths (17.5%). Women who died were significantly more likely to have any co-morbidity (AOR 3.63, 95% CI: 2.41-5.48), ruptured uterus (AOR 2.79, 95% CI: 1.48-5.28), macerated stillbirth (AOR 2.96, 95% CI 1.60-5.48) and to have had 6 or more previous births, (AOR 1.53, 95% CI 1.11-2.12), after adjusting for treatment received. These results suggest certain maternal conditions, particularly the presence of another life-threatening co-morbidity or macerated stillbirth, conferred a higher risk of mortality from PPH. This underscores the need for multi-system assessment and a comprehensive approach to the treatment of women with pregnancy complications.
Department of Obstetrics, Gynecology & Reproductive Sciences, University of California San Francisco, San Francisco, California, United States of America. elayadia@globalhealth.ucsf.edu
Alison
A
El Ayadi
Sarah
S
Raifman
Farouk
F
Jega
Elizabeth
E
Butrick
Yemisi
Y
Ojo
Stacie
S
Geller
Suellen
S
Miller
D000328:Adult; D001803:Blood Transfusion; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D005392:First Aid / Q000295:instrumentation; D006801:Humans; D008428:Maternal Mortality; D009549:Nigeria / Q000453:epidemiology; D006473:Postpartum Hemorrhage / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy*; D011247:Pregnancy; D050497:Stillbirth / Q000453:epidemiology; D016896:Treatment Outcome; D014599:Uterus / Q000293:injuries; D055815:Young Adult