Bulletin of the World Health Organization

Maternal near miss and maternal death in the World Health Organization’s 2005 global survey on maternal and perinatal health

João Paulo Souza, Jose Guilherme Cecatti, Anibal Faundes, Sirlei Siani Morais, Jose Villar, Guillermo Carroli, Metin Gulmezoglu, Daniel Wojdyla, Nelly Zavaleta, Allan Donner, Alejandro Velazco, Vicente Bataglia, Eliette Valladares, Marius Kublickas, Arnaldo Acosta & for the World Health Organization 2005 Global Survey on Maternal and Perinatal Health Research Group

Volume 88, Number 2, February 2010, 113-119

Table 1. Performance of various indicators of maternal morbidity as predictors of maternal death before hospital discharge, eight Latin American countries, 2005

Indicatora No. No. per 1000 deliveries No. of maternal deaths Ratio of no. to deaths Sensitivity (95% CI) Specificity (95% CI) Likelihood ratiob (95% CI)
Hysterectomy 151 1.56 7 22:1 28.0 (27.7–28.3) 99.9 (99.8–99.9) 249.7 (105.8–589.2)
ICU 1 102 11.35 12 92:1 48.0 (47.7–48.3) 98.9 (98.8–98.9) 80.4 (36.8–175.9)
Transfusion 1 340 13.80 9 149:1 36.0 (35.7–36.3) 98.6 (98.6–98.7) 40.2 (17.8–90.8)
Cardiac/renal complications 483 4.97 3 161:1 12.5 (12.3–12.7) 99.5 (99.4-99.6) 27.3 (8.2–90.8)
Eclampsia 253 2.61 1 253:1 4.0 (3.9–4.1) 99.7 (99.7–99.8) 15.9 (2.2–117.5)
Respiratory complication 593 6.11 1 593:1 4.2 (4.0–4.3) 99.4 (99.3–99.4) 6.8 (0.9–50.1)
Diabetes 742 7.64 1 742:1 4.0 (3.9–4.1) 99.2 (99.2–99.3) 5.4 (0.7–39.9)
Vaginal bleeding 2 134 21.98 2 1 067:1 8.0 (7.8–8.2) 97.8 (97.7–97.9) 3.9 (0.9–16.4)
Uterotonics 21 431 220.72 12 1 786:1 48.0 (47.7–48.3) 77.9 (77.6–78.1) 3.3 (1.5–7.1)
Hypertension 9 415 96.97 4 2 354:1 16.0 (15.8–16.2) 90.3 (90.1–90.5) 1.8 (0.6–5.2)
Referral 33 504 345.06 11 3 046:1 44.0 (43.7–44.3) 65.5 (65.2–65.8) 1.5 (0.7–3.3)
Pyelonephritis or any UTI 14 443 148.75 2 7 221:1 8.0 (7.8–8.2) 85.0 (84.8–85.2) 0.5 (0.1–2.1)

CI, confidence interval; ICU, intensive care unit; UTI, urinary tract infection.
a No deaths were identified in women with severe anaemia, malaria or sickle cell disease.
b A likelihood ratio > 10 denotes a strong association.

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