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. 2024 Jun 6;24(1):1526.
doi: 10.1186/s12889-024-18970-4.

Risk factors for maternal near-miss in an undeveloped province in south-central China, 2012-2022

Xu Zhou  1 , Junqun Fang  1 , Yinglan Wu  2 , Jie Gao  1 , Xiaoying Chen  3 , Aihua Wang  1 , Chuqiang Shu  1
Affiliations

Risk factors for maternal near-miss in an undeveloped province in south-central China, 2012-2022

Xu Zhou et al. BMC Public Health. .

Abstract

Objective: To explore the risk factors for maternal near-miss (MNM) using the WHO near-miss approach.

Methods: Data were obtained from the Maternal Near-Miss Surveillance System in Hunan Province, China, 2012-2022. Multivariate logistic regression analysis (method: Forward, Wald, α = 0.05) and adjusted odds ratios (aORs) were used to identify risk factors for MNM.

Results: Our study included 780,359 women with 731,185 live births, a total of 2461 (0.32%) MNMs, 777,846 (99.68%) non-MNMs, and 52 (0.006%) maternal deaths were identified. The MNM ratio was 3.37‰ (95%CI: 3.23-3.50). Coagulation/hematological dysfunction was the most common cause of MNM (75.66%). Results of multivariate logistic regression analysis showed risk factors for MNM: maternal age > = 30 years old (aOR > 1, P < 0.05), unmarried women (aOR = 2.21, 95%CI: 1.71-2.85), number of pregnancies > = 2 (aOR > 1, P < 0.05), nulliparity (aOR = 1.51, 95%CI: 1.32-1.72) or parity > = 3 (aOR = 1.95, 95%CI: 1.50-2.55), prenatal examinations < 5 times (aOR = 1.13, 95%CI: 1.01-1.27), and number of cesarean sections was 1 (aOR = 1.83, 95%CI: 1.64-2.04) or > = 2 (aOR = 2.48, 95%CI: 1.99-3.09).

Conclusion: The MNM ratio was relatively low in Hunan Province. Advanced maternal age, unmarried status, a high number of pregnancies, nulliparity or high parity, a low number of prenatal examinations, and cesarean sections were risk factors for MNM. Our study is essential for improving the quality of maternal health care and preventing MNM.

Keywords: Advanced maternal age; Cause; Epidemiology; Maternal near-miss; Risk factor.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Maternal near-miss ratios in Hunan Province, China, 2012–2022
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