Fetal and neonatal deaths among cases of maternal near miss.
OBJECTIVE
To determine the prevalence of fetal and neonatal deaths among patients with maternal near miss and the factors associated with this fatal outcome.


METHODS
The authors conducted a descriptive, cross-sectional, analyzing medical records of patients admitted to the ICU of a tertiary obstetric Recife (Brazil), between January 2007 and December 2010, who had at least one criterion of near miss defined by WHO. Statistical analysis was performed with Epi-Info 3.3.2, using chi-square and Fisher's exact test, considering a significance level of 5%. For multivariate analysis was constructed as a hierarchical model with the response variable fetal and neonatal deaths.


RESULTS
We included 246 cases of maternal near miss. Among women in the study, hypertensive disorders occurred in 62.7% to 41.2% in HELLP syndrome and the laboratory criteria for near miss in 59.6%. There were 48 (19.5%) stillbirths and 19 (7.7%) neonatal deaths. After analyzing the variables that remained statistically associated with fetal and neonatal deaths were: severe preeclampsia, placental abruption, endometritis, cesarean delivery, prematurity and the laboratory criteria for maternal near miss.


CONCLUSIONS
The high incidence of fetal and neonatal deaths among patients with maternal near miss. Among these women there is an overlap of factors contributing to this fatal outcome, in our study, those who had severe preeclampsia, placental abruption, endometritis, premature birth or laboratory criteria positively associated with deaths.
Unidade de ensino de pós-graduação em Saúde Materno Infantil, Instituto de Medicina Integral Prof. Fernando Figueira, Recife, PE, Brasil. Electronic address: leonam_costa@yahoo.com.br.
Leonam Costa
LC
Oliveira
Aurélio Antônio Ribeiro da
AA
Costa
D000037:Abruptio Placentae / Q000453:epidemiology; D000293:Adolescent; D000328:Adult; D001938:Brazil / Q000453:epidemiology; D003430:Cross-Sectional Studies; D004716:Endometritis / Q000453:epidemiology; D005260:Female; D005313:Fetal Death / Q000453:epidemiology*; D006801:Humans; D007223:Infant; D007226:Infant Mortality; D007231:Infant, Newborn; D016015:Logistic Models; D008875:Middle Aged; D054238:Perinatal Mortality; D011225:Pre-Eclampsia / Q000453:epidemiology; D011247:Pregnancy; D011248:Pregnancy Complications; D047928:Premature Birth / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D017741:Survivors; D055815:Young Adult
Fetal death; Morbidade materna grave; Near miss; Neonatal death; Severe maternal morbidity; Óbito fetal; Óbito neonatal