ArticlePloS one2019
Validity of WHO's near-miss approach in a high maternal mortality setting.
Article in PloS one, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 2 of them syntheses that pooled it.
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Who cites it
9 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Maternal mortality: near-miss events in middle-income countries, a systematic review.Bulletin of the World Health Organization · 2021Pooled it
- Human Development Index of the maternal country of origin and its relationship with maternal near miss: A systematic review of the literature.BMC pregnancy and childbirth · 2020Pooled it
- Measuring Severe Maternal Morbidity: Current Practices, Challenges, and Opportunities.Obstetrics and gynecology · 2026Review
- The multidimensional impact of maternal near-miss on the lives of women in Zanzibar, Tanzania: a prospective, 1-year follow-up study.AJOG global reports · 2023Article
- [Spatial analysis of maternal morbidity and mortality in users of the Brazilian Unified National Health System in the city of Rio de Janeiro, Brazil, 2014-2016].Cadernos de saude publica · 2023Article
- Indicators for maternal near miss: an observational study, India.Bulletin of the World Health Organization · 2022Observational
- Article
- Mental Health and Quality of Life of Women One Year after Maternal Near-Miss in Low and Middle-Income Countries: The Case of Zanzibar, Tanzania.International journal of environmental research and public health · 2020Article
- "I lost my happiness, I felt half dead and half alive" - a qualitative study of the long-term aftermath of obstetric near-miss in the urban district of Zanzibar, Tanzania.BMC pregnancy and childbirth · 2020Article
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo evaluate the validity of WHO's near-miss approach in a low-resource, high maternal mortality setting.
designProspective cohort study.
settingMnazi Mmoja Hospital, the main referral hospital of Zanzibar, Tanzania, from 1 April 2017 until 31 December 2018. POPULATION: All women, pregnant or until 42 days after the end of pregnancy, admitted at Mnazi Mmoja Hospital, the tertiary referral hospital in Zanzibar.
methodsCases of maternal morbidity and mortality were evaluated according to WHO's near-miss approach. The approach's performance was determined by calculating its accuracy through sensitivity, specificity and positive and negative likelihood ratios. The approach's validity was assessed with Pearson's correlation coefficient between the number of organ dysfunction markers and risk of mortality. MAIN OUTCOMES MEASURES: Correlation between number of organ dysfunction markers and risk of mortality, sensitivity and specificity.
results26,842 women were included. There were 335 with a severe maternal outcome: 256 maternal near-miss cases and 79 maternal deaths. No signs of organ dysfunction were documented in only 4 of the 79 cases of maternal death. The number of organ dysfunction markers was highly correlated to the risk of mortality with Pearson's correlation coefficient of 0.89.
conclusionsWHO's near-miss approach adequately identifies women at high risk of maternal mortality in Zanzibar's referral hospital. There is a strong correlation between the number of markers of organ dysfunction and mortality risk.
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