Effects of medical co‐morbidities on severe maternal morbidities in China: a multicenter clinic register study. (5th May 2015)

• Record Type: Journal Article
• Authors: Tan, Jing; Liu, Xing‐Hui; Yu, Chuan; Chen, Meng; Chen, Xiao‐Fan; Sun, Xin; Li, You‐Ping
• Is Part Of: Acta obstetricia et gynecologica Scandinavica. Volume 94:Number 8(2015)
• Page Start: 861
• Page End: 868
• Publication Date: 2015-05-05
• Subjects: Gynecology -- Periodicals; Pregnancy -- Periodicals; Obstetrics -- Periodicals; 618.05
• DOI: 10.1111/aogs.12657
• Languages: English
• ISSNs: 0001-6349

Abstract

<abstract abstract-type="main" id="aogs12657-abs-0001"> <title>Abstract</title> <sec id="aogs12657-sec-0001" sec-type="section"> <title>Objective</title> <p>To investigate the incidence of severe maternal morbidities (SMM) in China and explore effects of medical co‐morbidities on SMM.</p> </sec> <sec id="aogs12657-sec-0002" sec-type="section"> <title>Design</title> <p>Proactive multicenter clinic register collaboration.</p> </sec> <sec id="aogs12657-sec-0003" sec-type="section"> <title>Setting</title> <p>Data on all deliveries at eight hospitals in Sichuan province, China, collected from 1 January 2009 to 12 December 2010.</p> </sec> <sec id="aogs12657-sec-0004" sec-type="section"> <title>Population</title> <p>33 993 delivering women and 34 547 live births.</p> </sec> <sec id="aogs12657-sec-0005" sec-type="section"> <title>Methods</title> <p>We defined SMM as a combination indicator of severe maternal complications, critical interventions, admission to the intensive care unit and maternal near‐miss instances. We randomly selected 80% of the data from the entire database to build a logistic regression model. The remaining 20% were used to test the predictive power of the model.</p> </sec> <sec id="aogs12657-sec-0006" sec-type="section"> <title>Main outcome measures</title> <p>SMM incidence, adjusted odds ratios (aORs), and area under a receiver operating characteristic (ROC) curve.</p> </sec> <sec id="aogs12657-sec-0007" sec-type="section"> <title>Results</title> <p>Severe maternal morbidities incidence was 43.4/1000 live births [confidence interval (CI) 41.24–45.56]. Fifteen variables were independent contributors to the model. Seven medical co‐morbidities significantly affected the occurrence of SMM, including iron‐deficiency anemia (aOR 3.07, CI 2.47–3.83) and other hematological diseases (aOR 5.82, CI 3.50–9.69), hepatitis‐B virus infection (aOR 1.48, CI 1.12–1.97) and other hepatic diseases (aOR 3.81, CI 1.61–9.04), cardiopathy (aOR 3.59, CI 2.62–4.93), hypertension (aOR 5.23, CI 4.06–6.75), and respiratory diseases (aOR 2.10, CI 1.25–3.52). The area under the ROC curve was 0.8127.</p> </sec> <sec id="aogs12657-sec-0008" sec-type="section"> <title>Conclusions</title> <p>The incidence of SMM was typical of a low resource area. There is a need to identify medical co‐morbidities and to adopt prophylactic measures and interventions.</p> </sec> </abstract>