Effects of maternal near miss on neonatal Mortality in Bale Zone Southeast Ethiopia: prospective cohort study

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Date

2019-10

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Addis Abeba University

Abstract

Background: 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. It has very close effect on maternal and neonatal heath. Hence the study assess effect of maternal near miss on neonatal mortality. Methods: Prospective cohort study was done on 354 pregnant women who came for delivery service to selected hospitals in Bale Zone. The hospitals were selected purposely based on average number of delivery and neonatal mortality they have in the last six month. Then all mothers with near miss were included until the required sample size is obtained. Two non near miss mothers were selected using lottery. Frequency distribution was done for selected important variable. Survival curve for both groups and Cox regression to look for effect of maternal near miss on neonatal mortality was done. Ethical clearance from Addis Ababa University School of Public Health and verbal informed consent from study participant were obtained. Results: Out of the 384 sampled pregnant complete responses were obtained from 354 respondents yielding a response rate of 92.2%. . Of all 55 (15.5%) of them have previous history of abortion and 44 (12.4%) and 22(6.2%) have history of past delivery of still birth. From the total live birth there were 17 (48 per 1000 live birth) neonatal death at the end of the study. As monthly income increase by one Ethiopian birr the risk of neonatal mortality decrease by 0.002 [(AHR 0.998, 95% CI (0.996, 0.999)]; 6.48 times for non cephalic presentation than for cephalic presentation [(AHR 6.48,95% CI 1.84-22.73)]. As APGAR score increase by one score risk of neonatal mortality decrease by 0.2 [(AHR 0.746, 95% CI (0.620, 0.898)], 8.40 times for mother with severe morbidity than for mother with no maternal near miss after controlling for the effect of other variables (AHR 8.40, 95% CI (1.638, 43.118). Conclusion: Neonatal mortality was higher among near miss mothers. But it was not only the result of maternal complication. It has share from other factors. Therefore most of the factors were modifiable if efforts were done to improve socioeconomic status of community.

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Keywords

Maternal near miss, Neonatal mortality, Bale Zone, Ethiopia.

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