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Cited by 468Maternal and fetal healthcareGlobal Maternal and Child HealthPregnancy and preeclampsia studies

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WHO systematic review of maternal morbidity and mortality: the prevalence of severe acute maternal morbidity (near miss)

Open access
Say, Lale, Pattinson, Robert C, Gülmezoglu, A Metin·2004·Reproductive Health
DOI 10.1186/1742-4755-1-3PMC PMC516581
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Abstract

Aim: To determine the prevalence of severe acute maternal morbidity (SAMM) worldwide (near miss). Method: Systematic review of all available data. The methodology followed a pre-defined protocol, an extensive search strategy of 10 electronic databases as well as other sources. Articles were evaluated according to specified inclusion criteria. Data were extracted using data extraction instrument which collects additional information on the quality of reporting including definitions and identification of cases. Data were entered into a specially constructed database and tabulated using SAS statistical management and analysis software. Results: A total of 30 studies are included in the systematic review. Designs are mainly cross-sectional and 24 were conducted in hospital settings, mostly teaching hospitals. Fourteen studies report on a defined SAMM condition while the remainder use a response to an event such as admission to intensive care unit as a proxy for SAMM. Criteria for identification of cases vary widely across studies. Prevalences vary between 0.80% – 8.23% in studies that use disease-specific criteria while the range is 0.38% – 1.09% in the group that use organ-system based criteria and included unselected group of women. Rates are within the range of 0.01% and 2.99% in studies using management-based criteria. It is not possible to pool data together to provide summary estimates or comparisons between different settings due to variations in case-identification criteria. Nevertheless, there seems to be an inverse trend in prevalence with development status of a country. Conclusion: There is a clear need to set uniform criteria to classify patients as SAMM. This standardisation could be made for similar settings separately. An organ-system dysfunction/failure approach is the most epidemiologically sound as it is least open to bias, and thus could permit developing summary estimates.

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  • The search strategy and inclusion criteria were tailored for the purposes of this review.

    “Both the search strategy and inclusion criteria, which have been described elsewhere, were tailored for the purposes of this review [27, 28].”

    From The global prevalence of postpartum psychosis: a systematic review (2017) · cites this paper as [28]

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Research works printed but not linked: 35

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Metadata

Authors
Say, L., Pattinson, R. C., & Gülmezoglu, A. M.
Affiliations
  • World Health Organization (CH)
  • Kalafong Hospital (ZA)
Corresponding author
Say, Lale
ORCID
Venue
Reproductive Health
Publisher
Springer Science and Business Media LLC
Published
2004-08-17
Volume
1
Issue
1
Pages
3-3
ISSN
1742-4755 (ISSN-L)
DOI
10.1186/1742-4755-1-3
PMC
PMC516581
OpenAlex
W2110302356
Cited by
468
References
1
Citations by year
2026: 7 · 2025: 12 · 2024: 16 · 2023: 27 · 2022: 13 · 2021: 16 · 2020: 25 · 2019: 36 · 2018: 25 · 2017: 20 · 2016: 29 · 2015: 28 · 2014: 35 · 2013: 35 · 2012: 30
FWCI
1.23
Type
journal article
Language
en
Open access
Licence
Locations
  • Reproductive Health (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
  • UpSpace Institutional Repository (University of Pretoria) (submittedVersion, cc-by)
Topics
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Maternal and fetal healthcare
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Global Maternal and Child Health
  • Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy and preeclampsia studies
Keywords
severe maternal morbidity, near misses, maternal mortality, prevalence, organ dysfunction, intensive care unit admission

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