Uma abordagem abrangente para o estudo populacional do near miss materno / A comprehensive approach for population study of maternal near miss

AUTOR(ES)
DATA DE PUBLICAÇÃO

2008

RESUMO

Since the 1990s, a special group of women who survive severe complications of pregnancy has attracted the interest of researchers and public policymakers. A better understanding of this group, known as "near miss", could contribute to the development of health policies to improve maternal health. This doctoral thesis was developed with the wider aim of assessing whether the study of maternal near miss would be feasible through population surveys. To this end we developed a series of projects, implemented in three phases: preparation, development and validation of an instrument for the survey, and implementation (through a national survey of population and health). At the stage of preparation, information obtained by demographic health surveys conducted in Latin America and the Caribbean on maternal morbidity was analyzed. During the development and validation of the questionnaire, a systematic review was conducted and a pragmatic definition of near miss was developed. Womens experiences of severe maternal morbidity were evaluated. The findings from the first two phases supported the development of tool for population inquiries, which has undergone a validation study. The phase of implementation was possible due to incorporation of this questionnaire in the most recent national Demographic and Health Survey held in Brazil (2006/07). At the end of this process, and using a pragmatic definition, based on the occurrence of eclampsia, hysterectomy, admission to the ICU and blood transfusion, it is estimated the annual incidence of 54,000 cases of maternal near miss in Brazil, with prevalence around 20 cases/1.000 live births. Women aged >40 years or with low education are at increased risk of developing the condition. Overall, this thesis demonstrates the versatility of the concept of near miss, whose definition can be strict or pragmatic, and used for various purposes, including monitoring, surveillance, quality control and guidance of care. The versatility of the concept, the greater frequency of cases and the possibility of interviewing women support the purpose of studying the maternal near miss to guide local efforts in reducing

ASSUNTO(S)

indicadores de morbi-mortalidade complication maternal morbidity complicações na gravidez intensive care mortalidade materna near miss morbidade maternal mortality pregnancy cuidados intensivos near miss

ACESSO AO ARTIGO

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