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. 2018 May;141 Suppl 1(Suppl Suppl 1):10-19.
doi: 10.1002/ijgo.12464.

Standardizing the measurement of maternal morbidity: Pilot study results

Maria Barreix  1 , Kelli Barbour  2 , Affette McCaw-Binns  3 , Doris Chou  1 , Max Petzold  4 , Gathari N Gichuhi  5 , Luis Gadama  6 , Frank Taulo  6 , Özge Tunçalp  1 , Lale Say  1 ; WHO Maternal Morbidity Working Group (MMWG)
Collaborators, Affiliations

Standardizing the measurement of maternal morbidity: Pilot study results

Maria Barreix et al. Int J Gynaecol Obstet. 2018 May.

Abstract

Objective: To field test a standardized instrument to measure nonsevere morbidity among antenatal and postpartum women.

Methods: A cross-sectional study was conducted in Jamaica, Kenya, and Malawi (2015-2016). Women presenting for antenatal care (ANC) or postpartum care (PPC) were recruited if they were at least 28 weeks into pregnancy or 6 weeks after delivery. They were interviewed and examined by a doctor, midwife, or nurse. Data were collected and securely stored electronically on a WHO server. Diagnosed conditions were coded and summarized using ICD-MM.

Results: A total of 1490 women (750 ANC; 740 PPC) averaging 26 years of age participated. Most women (61.6% ANC, 79.1% PPC) were healthy (no diagnosed medical or obstetric conditions). Among ANC women with clinical diagnoses, 18.3% had direct (obstetric) conditions and 18.0% indirect (medical) problems. Prevalences among PPC women were lower (12.7% and 8.6%, respectively). When screening for factors in the expanded morbidity definition, 12.8% (ANC) and 11.0% (PPC) self-reported exposure to violence.

Conclusion: Nonsevere conditions are distinct from the leading causes of maternal death and may vary across pregnancy and the puerperium. This effort to identify and measure nonsevere morbidity promotes a comprehensive understanding of morbidity, incorporating maternal self-reporting of exposure to violence, and mental health. Further validation is needed.

Keywords: Antenatal care; Interpersonal violence; Maternal morbidity; Measurement; Nonsevere maternal morbidity; Postpartum care; Pregnancy and puerperium.

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