| Objective:In this study,we analyzed the data from Jilin province maternal near-miss report system,described the incidence of maternal near miss and maternal complications,and found those factors associated with maternal near miss and maternal complications.Thus,we can provide basis for the government to launch the right strategies to improve the obstetric treatment,lower the incidence of maternal near miss and maternal mortality.Methods:Data were collected from Jilin province maternal near-miss report system from January 1,2017 to December 31,2017.Excel were used to process and review the data.We adapted IBM SPSS 24.0 to analyze the data.The count data were expressed in percentage or ratio.Result differences were compared using the chi-square or Fisher exact test.Multiple stepwise logistic regressions were performed to assess the association.Results:1.A total of 50739 pregnant were collected from the Jilin province maternal near-miss report system.Among them,44138 were aged<35,which accounted for 87.0%,6601 were aged ?35 years,which accounted for 13.0%.26467 were with secondary technical school education level or below,accounting for 52.2%,24272 were with junior college education level or above,accounting for 47.8%.50374 were in marriage,accounting for 99.3%,365 were not in marriage,accounting for 0.7%.2.Among the 50,739 pregnant,most women were in the 5 times group of antenatal care,with a total of 47415,accounting for 93.4%.0 to 4 times of antenatal care group were with a total of 3324 patients,accounting for 6.6%.In terms of parity,the number of patients in group 0 times was the largest,with a total of 34,409,accounting for 67.8%.The number of parity in the group of 1 times was 16330,accounting for 32.2%.49960 with only one fetus,accounting for 98.5%,779 were multifetation,accounting for 1.5%.41,955 with no history of caesarean delivery,accounting for 82.7%,and 8,784 women in 1 time group,accounting for 17.3%.The number in 1 time gravidity group was 23,870,accounting for 47.0%.25,309 women in the 2 to 4 times groups,accounting for 49.9%.1,560 women in the groups of more than 5 times,accounting 3.1%.3.Among the 50739 pregnant,27405 developed complications,which account for 54.0%.Anemia was the most common complication among the 50739 pregnant,accounting for 26.78%.Premature rupture of membrane ranked the second,accounting for 16.54%.Diabetes ranked the third,accounting for 7.22%.Amniotic fluid anomaly ranked the fourth,accounting for 5.64%.Hypertension ranked the fifth,accounting for 4.72%.4.Women aged ?35 years(OR=1.390,95%CI 1.313~1.471),with junior college education level or above(OR=1.203,95%CI 1.160~1.247),2 to 4 times gravidity(OR=1.179,95%CI 1.125~1.235),more than 5 times gravidity(OR=1.560,95%CI 1.168~2.084),five times or more antenatal care(OR=1.482,95%CI 1.321~1.662)and multifetation(OR=1.287,95%CI 1.111~1.490)were significantly associated with the development of maternal complications.However,more than 1 times parity(OR=0.686,95%CI 0.651~0.723)were a protective factor.5.Among the 236 pregnant who developed maternal near-miss,Anemia was the most common complication,accounting for 81.36%.Obstetric hemorrhage ranked the second,accounting for 77.12%.Hypertension ranked the third,accounting for 15.68%.Premature rupture of membrane ranked the fourth,accounting for12.29%.Hypoproteinemia ranked the fifth,accounting for 8.47%.6.Women aged ?35 years(OR=1.641,95%CI 1.191~2.262),more than 5 times gravidity(OR=2.153,95%CI 1.285~3.605),history of caesarean delivery(OR=1.836,95%CI 1.330~2.534)and multifetation(OR=4.615,95%CI 2.810~7.582)were significantly associated with the developing of maternal near-miss.However,those with junior college education level or above(OR=0.516,95%CI 0.389~0.685)and those who have received five times or more antenatal care(OR=0.543,95%CI 0.375~0.785)had lower odds of experiencing maternal near-miss Conclusion:1.The sequence of maternal complications was anemia,premature rupture of membranes,diabetes mellitus,abnormal amniotic fluid,hypertension.2.Aged ?35 years,more than one times of gravidity,and multifetation were risk factors that associated with the developing of maternal complications.More than 1 times parity can be a protective factor for maternal complications.3.The sequence of maternal complications in maternal near miss was anemia,bleeding,hypertension,premature rupture of membranes,hypoalbuminemia.4.Aged ?35 years,more than 5 times gravidity,history of caesarean delivery and multifetation were risk factors that associated with the developing of maternal near-miss.However,antenatal care and junior college education level or above can be protective factors to lower the incidence of maternal near-miss. |
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