Maternal near misses (MNM) and their determinants among women who sought obstetric care from fort portal regional referral hospital, Western Uganda

Abstract

Maternal near misses (MNM) involve near-death experiences and are associated with severe maternal morbidity, not limited to severe postpartum hae-morrhage, sepsis and organ dysfunction. Maternal near-misses are quite common in Ugandan health facilities. This study aimed to assess the prevalence and determi-nants of maternal near misses among women who sought obstetric care from Fort Portal Regional Referral Hospital, western Uganda. A retrospective cohort study that targeted 375 women who had received maternal healthcare services from Fort Portal regional referral hospital was undertaken. It was found that, overall, the prevalence of MNM was 61.3%, with sepsis being the commonest determinant [187 (81.3%)]. Eight individual characteristics had statistically significant relationships with MNM; residence type (p = 0.000), trimester of initiation of ANC (p = 0.000), ANC attendance (p = 0.048), delivery of recent pregnancy in health facility (p = 0.000), delivery at Fort Portal regional referral hospital (p = 0.000), referred from other facilities (p = 0.000), age (p = 0.037), marital status (p = 0.000) and district of residence (p = 0.000). The prevalence of MNM was higher among women who were of rural residence at 45.6% (aPR = 1.409 [1.330–1.493], p = 0.000), compared to those who were of urban residence. MNM prevalence was very high among mothers who never attended ANC at 3.2% and thus, less among those who had attended ANC during pregnancy (cPR = 0.652 [0.216–0.981], p = 0.048). Conclusively, the prevalence of MNM was substantially high.