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. 2023 Dec 31;16(1):2269736.
doi: 10.1080/16549716.2023.2269736. Epub 2023 Oct 27.

Neonatal outcomes according to different degrees of maternal morbidity: cross-sectional evidence from the Perinatal Information System (SIP) of the CLAP network

Mercedes Colomar  1 , Bremen de Mucio  1 , Claudio Sosa  1 , Rodolfo Gomez  1 , Luis Mainero  1 , Renato T Souza  2 , Maria L Costa  2 , Adriana G Luz  2 , Maria H Sousa  3 , Carmen M Cruz  4 , Luz M Chevez  4 , Rita Lopez  4 , Gema Carrillo  5 , Ulises Rizo  5 , Erika E Saint Hillaire  6 , William E Arriaga  7 , Rosa M Guadalupe  7 , Carlos Ochoa  8 , Freddy Gonzalez  9 , Rigoberto Castro  9 , Allan Stefan  10 , Amanda Moreno  11 , Suzanne J Serruya  1 , José G Cecatti  2
Affiliations

Neonatal outcomes according to different degrees of maternal morbidity: cross-sectional evidence from the Perinatal Information System (SIP) of the CLAP network

Mercedes Colomar et al. Glob Health Action. .

Abstract

Background: The burden of maternal morbidity in neonatal outcomes can vary with the adequacy of healthcare provision and tool implementation to improve monitoring. Such information is lacking in Latin American countries, where the decrease in severe maternal morbidity and maternal death remains challenging.

Objectives: To determine neonatal outcomes according to maternal characteristics, including different degrees of maternal morbidity in Latin American health facilities.

Methods: This is a secondary cross-sectional analysis of the Perinatal Information System (SIP) database from eight health facilities in five Latin American and Caribbean countries. Participants were all women delivering from August 2018 to June 2021, excluding cases of abortion, multiple pregnancies and missing information on perinatal outcomes. As primary and secondary outcome measures, neonatal near miss and neonatal death were measured according to maternal/pregnancy characteristics and degrees of maternal morbidity. Estimated adjusted prevalence ratios (PRadj) with their respective 95% CIs were reported.

Results: In total 85,863 live births were included, with 1,250 neonatal near miss (NNM) cases and 695 identified neonatal deaths. NNM and neonatal mortality ratios were 14.6 and 8.1 per 1,000 live births, respectively. Conditions independently associated with a NNM or neonatal death were the need for neonatal resuscitation (PRadj 16.73, 95% CI [13.29-21.05]), being single (PRadj 1.45, 95% CI [1.32-1.59]), maternal near miss or death (PRadj 1.64, 95% CI [1.14-2.37]), preeclampsia (PRadj 3.02, 95% CI [1.70-5.35]), eclampsia/HELPP (PRadj 1.50, 95% CI [1.16-1.94]), maternal age (years) (PRadj 1.01, 95% CI [<1.01-1.02]), major congenital anomalies (PRadj 3.21, 95% CI [1.43-7.23]), diabetes (PRadj 1.49, 95% CI [1.11-1.98]) and cardiac disease (PRadj 1.65, 95% CI [1.14-2.37]).

Conclusion: Maternal morbidity leads to worse neonatal outcomes, especially in women suffering maternal near miss or death. Based on SIP/PAHO database all these indicators may be helpful for routine situation monitoring in Latin America with the purpose of policy changes and improvement of maternal and neonatal health.

Keywords: Latin America; Neonatal morbidity; maternal morbidity; maternal near miss; neonatal mortality.

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Conflict of interest statement

The authors declare they do not have competing interests. Authors who are staff members of the Pan American and World Health Organization are responsible for the views expressed in this publication. Their views do not necessarily represent the decisions or policies of the Pan American Health Organization.

Figures

Figure 1.
Figure 1.
Flowchart of participants in the study according to perinatal outcomes (SIP-PAHO, 2018–2021).
See this image and copyright information in PMC

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