Severe maternal morbidity: a case-control study in Maranhao, Brazil.

Area of Science:

• Public Health
• Obstetrics & Gynecology
• Epidemiology

Background:

• Maternal mortality and morbidity are critical public health issues in Brazil, disproportionately affecting disadvantaged women.
• Severe maternal morbidity presents a significant challenge, particularly in socioeconomically vulnerable populations.
• A case-control study was initiated in Sao Luis, a low-income Brazilian capital, to investigate risk factors.

Purpose of the Study:

• To identify key risk factors associated with severe maternal morbidity.
• To inform public health strategies aimed at reducing maternal complications.
• To highlight the importance of targeted interventions for high-risk pregnancies.

Main Methods:

• A case-control study conducted in high-risk maternity facilities and intensive care units.
• Inclusion criteria for cases involved severe complications during pregnancy, childbirth, or postpartum (up to 42 days).
• Data collection involved structured interviews, medical records, and prenatal cards, encompassing sociodemographic, clinical, obstetric, and behavioral factors.

Main Results:

• Advanced maternal age (over 35) was significantly associated with severe maternal morbidity (OR=3.11).
• Pre-existing hypertension (OR=2.52) and a history of abortion (OR=1.61) were identified as independent risk factors.
• Receiving 1-3 (OR=1.89) or 4-5 (OR=1.78) prenatal consultations showed an association with increased risk, suggesting a complex relationship with care intensity.

Conclusions:

• The findings underscore the critical role of comprehensive reproductive healthcare.
• Early identification of high-risk pregnancies is essential for effective prevention strategies.
• Qualified and complete prenatal care is vital for mitigating severe maternal morbid events.