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. 2020 Jul;150(1):83-91.
doi: 10.1002/ijgo.13161. Epub 2020 May 3.

General and reproductive health among women after an episode of severe maternal morbidity: Results from the COMMAG study

Elton C Ferreira  1 , Maria L Costa  1 , Rodolfo C Pacagnella  1 , Carla Silveira  1 , Carla B Andreucci  1   2 , Dulce M Zanardi  1 , Juliana P Santos  1 , Carina R Angelini  1 , Renato T Souza  1 , Mary A Parpinelli  1 , Maria H Sousa  3 , Jose G Cecatti  1
Affiliations

General and reproductive health among women after an episode of severe maternal morbidity: Results from the COMMAG study

Elton C Ferreira et al. Int J Gynaecol Obstet. 2020 Jul.

Abstract

Objective: To assess general and reproductive health in women after severe maternal morbidity (SMM).

Methods: A retrospective cohort study was performed at a tertiary maternity hospital. Women with SMM criteria who delivered during 2008-2012 were included in the SMM group. The control group included a random sample of women without SMM delivering in the same year of cases. Both groups were compared regarding sociodemographic/obstetric characteristics, general and reproductive health, using χ2 , Yates χ2 , Fisher exact, and Mann-Whitney tests.

Results: There were 315 women in the SMM group and 323 women in the control group. The SMM group was older and had a history of more medical conditions (hypertension, diabetes, obesity), cesarean deliveries, preterm births, and perinatal deaths. Breastfeeding was negatively affected in these women, as was fertility. The SMM group had a non-significant trend of fewer children after index pregnancy, had new complications in subsequent pregnancies, and required specialized medical care, besides higher risk of death.

Conclusion: Women experiencing SMM are at higher risk of general and reproductive health problems after pregnancy, including risk of death. Therefore, their surveillance and follow-up should continue beyond 42 days postpartum, highlighting the importance of more specialized health care.

Keywords: General health; Maternal death; Maternal near miss; Postpartum period; Pregnancy; Reproductive health; Severe maternal morbidity.

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