A global view of severe maternal morbidity: moving beyond maternal mortality
Abstract Background Maternal mortality continues to be of great public health importance, however for each woman who dies as the direct or indirect result of pregnancy, many more women experience life-threatening complications. The global burden of severe maternal morbidity (SMM) is not known, but t...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2018-06-01
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| Series: | Reproductive Health |
| Online Access: | http://link.springer.com/article/10.1186/s12978-018-0527-2 |
| _version_ | 1818948903029964800 |
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| author | Stacie E. Geller Abigail R. Koch Caitlin E. Garland E. Jane MacDonald Francesca Storey Beverley Lawton |
| author_facet | Stacie E. Geller Abigail R. Koch Caitlin E. Garland E. Jane MacDonald Francesca Storey Beverley Lawton |
| author_sort | Stacie E. Geller |
| collection | DOAJ |
| description | Abstract Background Maternal mortality continues to be of great public health importance, however for each woman who dies as the direct or indirect result of pregnancy, many more women experience life-threatening complications. The global burden of severe maternal morbidity (SMM) is not known, but the World Bank estimates that it is increasing over time. Consistent with rates of maternal mortality, SMM rates are higher in low- and middle-income countries (LMICs) than in high-income countries (HICs). Severe maternal morbidity in high-income countries Since the WHO recommended that HICs with low maternal mortality ratios begin to examine SMM to identify systems failures and intervention priorities, researchers in many HICs have turned their attention to SMM. Where surveillance has been conducted, the most common etiologies of SMM have been major obstetric hemorrhage and hypertensive disorders. Of the countries that have conducted SMM reviews, the most common preventable factors were provider-related, specifically failure to identify “high risk” status, delays in diagnosis, and delays in treatment. Severe maternal morbidity in low and middle income countries The highest burden of SMM is in Sub-Saharan Africa, where estimates of SMM are as high as 198 per 1000 live births. Hemorrhage and hypertensive disorders are the leading conditions contributing to SMM across all regions. Case reviews are rare, but have revealed patterns of substandard maternal health care and suboptimal use of evidence-based strategies to prevent and treat morbidity. Effects of SMM on delivery outcomes and infants Severe maternal morbidity not only puts the woman’s life at risk, her fetus/neonate may suffer consequences of morbidity and mortality as well. Adverse delivery outcomes occur at a higher frequency among women with SMM. Reducing preventable severe maternal morbidity not only reduces the potential for maternal mortality but also improves the health and well-being of the newborn. Conclusion Increasing global maternal morbidity is a failure to achieve broad public health goals of improved women’s and infants’ health. It is incumbent upon all countries to implement surveillance initiatives to understand the burden of severe morbidity and to implement review processes for assessing potential preventability. |
| first_indexed | 2024-12-20T08:54:11Z |
| format | Article |
| id | doaj.art-65b9877dacb94041bdd16c3d697fce28 |
| institution | Directory Open Access Journal |
| issn | 1742-4755 |
| language | English |
| last_indexed | 2024-12-20T08:54:11Z |
| publishDate | 2018-06-01 |
| publisher | BMC |
| record_format | Article |
| series | Reproductive Health |
| spelling | doaj.art-65b9877dacb94041bdd16c3d697fce282022-12-21T19:46:04ZengBMCReproductive Health1742-47552018-06-0115S1314310.1186/s12978-018-0527-2A global view of severe maternal morbidity: moving beyond maternal mortalityStacie E. Geller0Abigail R. Koch1Caitlin E. Garland2E. Jane MacDonald3Francesca Storey4Beverley Lawton5Departments of Obstetrics & Gynecology and Medicine, University of Illinois at Chicago College of MedicineCenter for Research on Women and Gender, University of Illinois at Chicago College of MedicineCenter for Research on Women and Gender, University of Illinois at Chicago College of MedicineCentre for Women’s Health Research, Victoria University of WellingtonCentre for Women’s Health Research, Victoria University of WellingtonCentre for Women’s Health Research, Victoria University of WellingtonAbstract Background Maternal mortality continues to be of great public health importance, however for each woman who dies as the direct or indirect result of pregnancy, many more women experience life-threatening complications. The global burden of severe maternal morbidity (SMM) is not known, but the World Bank estimates that it is increasing over time. Consistent with rates of maternal mortality, SMM rates are higher in low- and middle-income countries (LMICs) than in high-income countries (HICs). Severe maternal morbidity in high-income countries Since the WHO recommended that HICs with low maternal mortality ratios begin to examine SMM to identify systems failures and intervention priorities, researchers in many HICs have turned their attention to SMM. Where surveillance has been conducted, the most common etiologies of SMM have been major obstetric hemorrhage and hypertensive disorders. Of the countries that have conducted SMM reviews, the most common preventable factors were provider-related, specifically failure to identify “high risk” status, delays in diagnosis, and delays in treatment. Severe maternal morbidity in low and middle income countries The highest burden of SMM is in Sub-Saharan Africa, where estimates of SMM are as high as 198 per 1000 live births. Hemorrhage and hypertensive disorders are the leading conditions contributing to SMM across all regions. Case reviews are rare, but have revealed patterns of substandard maternal health care and suboptimal use of evidence-based strategies to prevent and treat morbidity. Effects of SMM on delivery outcomes and infants Severe maternal morbidity not only puts the woman’s life at risk, her fetus/neonate may suffer consequences of morbidity and mortality as well. Adverse delivery outcomes occur at a higher frequency among women with SMM. Reducing preventable severe maternal morbidity not only reduces the potential for maternal mortality but also improves the health and well-being of the newborn. Conclusion Increasing global maternal morbidity is a failure to achieve broad public health goals of improved women’s and infants’ health. It is incumbent upon all countries to implement surveillance initiatives to understand the burden of severe morbidity and to implement review processes for assessing potential preventability.http://link.springer.com/article/10.1186/s12978-018-0527-2 |
| spellingShingle | Stacie E. Geller Abigail R. Koch Caitlin E. Garland E. Jane MacDonald Francesca Storey Beverley Lawton A global view of severe maternal morbidity: moving beyond maternal mortality Reproductive Health |
| title | A global view of severe maternal morbidity: moving beyond maternal mortality |
| title_full | A global view of severe maternal morbidity: moving beyond maternal mortality |
| title_fullStr | A global view of severe maternal morbidity: moving beyond maternal mortality |
| title_full_unstemmed | A global view of severe maternal morbidity: moving beyond maternal mortality |
| title_short | A global view of severe maternal morbidity: moving beyond maternal mortality |
| title_sort | global view of severe maternal morbidity moving beyond maternal mortality |
| url | http://link.springer.com/article/10.1186/s12978-018-0527-2 |
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