ArticleBMC pregnancy and childbirth2014
Delays in receiving obstetric care and poor maternal outcomes: results from a national multicentre cross-sectional study.
Article in BMC pregnancy and childbirth, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 123 papers, 9 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
123 citing papers in PubMed, 9 syntheses or guidelines pooled it.
- Men's knowledge of obstetrics danger sign and associated factors in low-income countries: a systematic review and meta-analysis.Scientific reports · 2025Pooled it
- Global burden of potentially life-threatening maternal conditions: a systematic review and meta-analysis.BMC pregnancy and childbirth · 2024Pooled it
- A systematic review of individual and ecological determinants of maternal mortality in the world based on the income level of countries.BMC public health · 2022Pooled it
- Obstructed labor and its effect on adverse maternal and fetal outcomes in Ethiopia: A systematic review and meta-analysis.PloS one · 2022Pooled it
- WOMEN's Knowledge of Obstetric Danger signs in Ethiopia (WOMEN's KODE):a systematic review and meta-analysis.Systematic reviews · 2019Pooled it
- Barriers to access and utilization of emergency obstetric care at health facilities in sub-Saharan Africa: a systematic review of literature.Systematic reviews · 2018Pooled it
- Access barriers to obstetric care at health facilities in sub-Saharan Africa-a systematic review.Systematic reviews · 2017Pooled it
- Neonatal Near Miss: the need for a standard definition and appropriate criteria and the rationale for a prospective surveillance system.Clinics (Sao Paulo, Brazil) · 2015Pooled it
- Severe maternal outcomes and their underlying causes in Ethiopia. Systematic review and meta-analysis.Women's health (London, England)Pooled it
- Improved maternal-fetal outcomes among emergency obstetric referrals following phone call communication at a teaching hospital in south western Uganda: a quasi-experimental study.BMC pregnancy and childbirth · 2022Trial
- Facing the COVID-19 pandemic inside maternities in Brazil: A mixed-method study within the REBRACO initiative.PloS one · 2021Trial
- High-risk pregnancies and their association with severe maternal morbidity in Nepal: A prospective cohort study.PloS one · 2020Trial
- Will district health centres use preloaded cell phones for pre-referral phone calls for women in labour: a randomized pilot study at Mbarara Regional Referral Hospital in southwest Uganda.Canadian journal of public health = Revue canadienne de sante publique · 2019Trial
- Validation of the fullPIERS model for predicting severe maternal outcomes in preeclampsia in five Brazilian centers.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2026Article
- The relationship between prolonged travel and mortality among women with complicated deliveries in rural Kenya.Journal of global health · 2026Article
- Understanding stillbirths and maternal deaths in Pakistan: evidence from a national household survey.Journal of global health · 2026Article
- Indicators from training healthcare providers on WHO-recommended best practices in prenatal care in Brazil: A before-and-after study.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2026Article
- Surviving Severe Obstetric Complications: A Population-Based Analysis of Maternal near Miss.Medical sciences (Basel, Switzerland) · 2026Article
- Direct versus referred admission to the maternity hospital due to preeclampsia: Does it influence pregnancy outcomes?International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2026Article
- Prevalence of Maternal Third Delays in Emergency Obstetric Care and Determinant Factors Among Women Giving Birth in Government Hospitals in East Gojjam Zone, Northwest Ethiopia: A Cross-Sectional Study.Health science reports · 2026Article
63 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe vast majority of maternal deaths in low-and middle-income countries are preventable. Delay in obtaining access to appropriate health care is a fairly common problem which can be improved. The objective of this study was to explore the association between delay in providing obstetric health care and severe maternal morbidity/death.
methodsThis was a multicentre cross-sectional study, involving 27 referral obstetric facilities in all Brazilian regions between 2009 and 2010. All women admitted to the hospital with a pregnancy-related cause were screened, searching for potentially life-threatening conditions (PLTC), maternal death (MD) and maternal near-miss (MNM) cases, according to the WHO criteria. Data on delays were collected by medical chart review and interview with the medical staff. The prevalence of the three different types of delays was estimated according to the level of care and outcome of the complication. For factors associated with any delay, the PR and 95%CI controlled for cluster design were estimated.
resultsA total of 82,144 live births were screened, with 9,555 PLTC, MNM or MD cases prospectively identified. Overall, any type of delay was observed in 53.8% of cases; delay related to user factors was observed in 10.2%, 34.6% of delays were related to health service accessibility and 25.7% were related to quality of medical care. The occurrence of any delay was associated with increasing severity of maternal outcome: 52% in PLTC, 68.4% in MNM and 84.1% in MD.
conclusionsAlthough this was not a population-based study and the results could not be generalized, there was a very clear and significant association between frequency of delay and severity of outcome, suggesting that timely and proper management are related to survival.
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