The Morbidity And Risk Factors Of Maternal Near Miss Disease In Hebei Province:A Cross-Sectional Study

Objectives To analyze the epidemiological characteristics of maternal comorbidities or complications and risk factors in Hebei Province.Methods It was a multi-center retrospective study.The data was collected from Hebei Province Maternal Near Miss Surveillance System(HBMNMSS).The system was funded by the government,involved 22 monitoring hospitals that were randomly cluster sampled in Hebei Province.The incidence of maternal comorbidities or complications and Maternal Near Miss were analyzed,and multivariate logistic regression analysis was performed on their risk factors.Results(1)From 2013 to 2017,a total of 289,895 pregnant women who were delivered in hospital at 22 surveillance sites in Hebei Province were excluded.19,583 cases that did not meet the criteria were excluded,and 270,312 cases were included in the criteria(2)Of the 270,312 pregnant women included in the analysis,90,563 had maternal complications or complications,with an incidence of 33.50%.The incidence of maternal comorbidities or complications in Hebei Province is increasing year by year,but maternal near miss as a whole shows a downward trend.551 maternal near miss,with an incidence rate of 2.03 ‰,the lowest incidence of critically ill pregnant women in 2016;(3)Among the major comorbidities or complications of pregnant women,the highest incidence was anemia of 70,606 cases(26.12%),followed by 12,585 cases of hypertension(4.66%),diabetes of 10716 cases(3.96%),and the lowest incidence was 104 cases of pulmonary disease(0.04%);The highest incidence of maternal near miss was 342 cases(0.13%)of coagulopathy,and the lowest incidence was 13 cases of liver dysfunction(4.81/100,000)(4)There are differences in the incidence of comorbidities or complications and maternal near miss;(5)Multivariate logistic regression analysis using adjusted factors such as age,education level,delivery method,parity,pregnancy,previous cesarean section history,urban and rural,and number of fetuses showed that: 35 to 39 years OR(95%CI): 1.17(1.13 ~ 1.21),?40 years OR(95%CI): 1.28(1.20 ~ 1.37),and cesarean delivery OR(95%CI): 1.43(1.40 ~1.46),high school / secondary school OR(95%CI): 1.10(1.08~ 1.13),pregnancy ? 2 OR(95%CI): 1.13(1.10 ~ 1.11),cesarean section history OR(95%CI): 1.24(1.21 ~ 1.27)and multiple births OR(95%CI): 1.58(1.49 ~ 1.68)were independent risk factors for maternal complications or complications;<20 years OR(95%CI): 2.16(1.23~ 3.78),cesarean delivery OR(95%CI): 3.99(3.12~ 5.12),high school / secondary school OR(95%CI): 2.06(1.62~ 2.62),junior high school and below OR(95%CI): 4.31(3.36 ~ 5.51),postpartum OR(95%CI): 1.99(1.35 ~2.93),and multiple births OR(95%CI): 1.57(1.10~ 2.25)is an independent risk factor for maternal near miss.Conclusions 1.From 2013 to 2017,the incidence of comorbidities or complications among pregnant women in Hebei Province has been increasing year by year;the overall severity of maternal near miss has been declining;there are differences between regions.2.The highest incidence of comorbidities or complications among pregnant women in Hebei Province is anemia,followed by hypertension and gestational diabetes;the highest incidence of maternal near miss is coagulopathy,and the lowest incidence is liver dysfunction.3.Old age is an independent risk factor for pregnancy complications or complications;young age is an independent risk factor for critical illness.Cesarean section delivery,low education level,multiple births,et al.are independent risk factors for pregnancy comorbidities or complications,as well as maternal near miss.Figure [22];Table[1];Reference [42]...