Magnitude and determinants of maternal near miss in nekemte specialized hospital, east wollega zone, western Ethiopia

Abstract

Background: Maternal Near Miss is one of the related concepts to maternal mortality where women survive merely by chance, luck, or by good hospital care .Maternal near miss is ‗a woman who nearly died but survived a complication that occurred during pregnancy, childbirth or within 42 days of termination of pregnancy. Maternal near miss is a promising indicator to improve the quality of obstetric care and it is a direct indicator to reduce maternal mortality to attain the Sustainable Development Goal by 2030, as Ethiopia is expected to do more. Objectives: To determine magnitude and assess determinants of maternal near miss cases in Nekemte specialized Hospital, western Ethiopia from May 1,2018. Methods:-Hospital based unmatched case-control study design was conducted from a total of 183 mothers from which 61 mothers were with maternal near miss cases and 122 mothers as controls in Nekemte Specialized Hospital during the study period. Data on maternal near miss case was collected using Semi-structured questioner from maternal near miss cases Who were recruited consecutively in the study and two consecutive controls following each near miss cases. The collected data was checked, entered into Epi data version 3.1 and transported to and analyzed using SPSS version 22. Descriptive statistics was used to assess the frequency of dependent and independent variable, Binary logistic regression and multivariate logistic regression was used to examine association between dependent and each independent variables. A 95% CI and p-value of <0.05 was considered to be statistically significant Result: The magnitude of maternal near miss cases were 4.97%. Multivariate logistic regression analysis reveals High gravidity has four times [AOR: 3.84 [95% CI: 1.23-11.91]], having no ANC follow up is six times more likely, [AOR: 6.02[95%CI:1.55-23.28]], prolonged second degree delay12 times more likely [AOR:12[2.55-56.57]] and those with induced labor are nine times more likely [AOR :9.4[2.97-29.71]] to develop near miss events. The major causes of maternal near miss events were; severe obstetric hemorrhage (55.74%) followed by hypertension during pregnancy 40.98% (29.5% Severe pre eclampsia, 11.48% Eclampsia). Conclusion : The magnitude of maternal near miss cases were relatively slower than studies done in other parts of the country. The study showed that multigravidity, having no antenatal care follow up, prolonged second degree delay and induction of labor were significantly associated determinants to cause maternal near miss cases.