Severe maternal morbidity in the Asia Pacific: a systematic review and meta-analysis
| العنوان: | Severe maternal morbidity in the Asia Pacific: a systematic review and meta-analysis |
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| المؤلفون: | Anna Middleton, Anthea Lindquist, Susan P. Walker, Benjamin Koete, Roxanne Hastie, Joshua P. Vogel, Leeanne Panisi, Manarangi De Silva, Catherine Cluver, Stephen Tong |
| المصدر: | The Lancet Regional Health. Western Pacific, Vol 14, Iss, Pp 100217-(2021) The Lancet Regional Health: Western Pacific |
| بيانات النشر: | Elsevier, 2021. |
| سنة النشر: | 2021 |
| مصطلحات موضوعية: | MEDLINE, Near miss, LMIC, Internal Medicine, Medicine, Socioeconomic status, Eclampsia, business.industry, Health Policy, Asia-Pacific, Public Health, Environmental and Occupational Health, Obstetrics and Gynecology, Maternal death, medicine.disease, Near-miss, Uterine rupture, Psychiatry and Mental health, Infectious Diseases, Meta-analysis, Pediatrics, Perinatology and Child Health, Cohort, Geriatrics and Gerontology, Public aspects of medicine, RA1-1270, business, Research Paper, Demography, Maternal morbidity |
| الوصف: | Background: Monitoring rates of severe maternal morbidity (such as eclampsia and uterine rupture) is useful to assess the quality of obstetric care, particularly in low and lower-middle-income countries (LMICs). Methods: We undertook a systematic review characterising the proportion and causes of severe maternal morbidity in the Asia Pacific region. We searched Medline, Embase, Cochrane CENTRAL library and the World Health Organization Western Pacific Index database for studies in the Asia-Pacific reporting maternal morbidity/near miss using a predefined search strategy. We included cohort, case-control and cross-sectional studies published in English before September 2020. A meta-analysis was performed calculating the overall proportion of near miss events by sub-region, country, near miss definition, economic status, setting and cause using a random-effects model. Findings: We identified 26,232 articles, screened 24,306 and retrieved 454 full text articles. Of these, 197 studies spanning 27 countries were included. 13 countries in the region were not represented. There were 30,183,608 pregnancies and 100,011 near misses included. The total proportion of near miss events was 4•4 (95% CI 4•3-4•5) per 1000 total births. The greatest proportion of near misses were found in the Western Pacific region (around Papua New Guinea) at 11•8 per 1000 births (95% CI 6•6-17•1; I2 96.05%). Low-income countries displayed the greatest proportion of near misses (13•4, 95% CI 6•0-20•7), followed by lower-middle income countries (11•1; 95% CI 10•4 - 11•9). High-income countries had the lowest proportion (2•2, 95% CI 2•1-2•3). Postpartum haemorrhage was the most common near miss event (5•9, 95% CI 4•5-7•2), followed by eclampsia (2•7, 95% CI 2•4 - 2•9). Interpretation: There is a high burden of severe maternal morbidity in the Asia-Pacific. LMICs are disproportionately affected. Most of the common causes are preventable. This provides an opportunity to implement targeted interventions which could have major clinical impact. |
| اللغة: | English |
| تدمد: | 2666-6065 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::1d6fb7d2c61035457666b4e2033dbdfbTest http://www.sciencedirect.com/science/article/pii/S2666606521001267Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....1d6fb7d2c61035457666b4e2033dbdfb |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 26666065 |
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