Maternal morbidity and near miss associated with maternal age: the innovative approach of the 2006 Brazilian demographic health survey.

Abstract

OBJECTIVE:

To study the prevalence of potentially life-threatening maternal conditions and near miss in Brazil according to maternal age.

METHODS:

A secondary analysis of the 2006 Brazilian demographic health survey database using a validated questionnaire to evaluate maternal morbidity with a focus on age extremes. The study included 5,025 women with at least 1 live birth in the 5-year reference period preceding their interviews. Three age range periods were used: 15-19 years (younger age), 20-34 years (control), and 35-49 years (advanced maternal age). According to a pragmatic definition, any woman reporting eclampsia, hysterectomy, blood transfusion, or admission to the intensive care unit during her pregnancy/childbirth was considered a near-miss case. The associations between age and severe maternal morbidity were further assessed.

RESULTS:

For the 6,833 reported pregnancies, 73.7% of the women were 20-34 years old, 17.9% were of advanced maternal age, and only 8.4% were of younger age. More than 22% of the women had at least one of the complications appraised, and blood transfusion, which was more prevalent among the controls, was the only variable with a significant difference among the age groups. The overall rate of maternal near miss was 21.1 per 1000 live births. There was a trend of higher maternal near miss with increasing age. The only significant risk factor identified for maternal near miss was a lower literacy level among older women.

CONCLUSIONS:

There is a trend towards worse results with increasing age. The investigation of the determinants of maternal near miss at the community level using an innovative approach through a demographic health survey is an example suggested for under-resourced settings.

• Authors: Fernando César de Oliveira Jr, Maria Laura Costa, Jose Guilherme Cecatti, João Luiz Pinto e Silva, Fernanda Garanhani Surita
• Journal: Clinics (Sao Paulo, Brazil) (Clinics (Sao Paulo)) Vol. 68 Issue 7 Pg. 922-7 (Jul 2013) ISSN: 1980-5322 [Electronic] United States
• PMID: 23917654 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Adolescent
• Adult
• Brazil (epidemiology)
• Female
• Gestational Age
• Health Surveys
• Humans
• Maternal Age
• Maternal Mortality
• Middle Aged
• Morbidity
• Pregnancy
• Pregnancy Complications (epidemiology)
• Pregnancy Outcome (epidemiology)
• Risk Factors
• Socioeconomic Factors
• Young Adult