Risk of maternal mortality in women with severe anaemia during pregnancy and post partum: a multilevel analysis

Summary: Background: Anaemia affects as many as half of all pregnant women in low-income and middle-income countries, but the burden of disease and associated maternal mortality are not robustly quantified. We aimed to assess the association between severe anaemia and maternal death with data from t...

Full description

Saved in:
Bibliographic Details
Main Authors: Jahnavi Daru, MBBS (Author), Javier Zamora, ProfPhD (Author), Borja M Fernández-Félix, MSc (Author), Joshua Vogel, PhD (Author), Olufemi T Oladapo, FWACS (Author), Naho Morisaki, PhD (Author), Özge Tunçalp, PhD (Author), Maria Regina Torloni, PhD (Author), Suneeta Mittal, MD (Author), Kapila Jayaratne, MD (Author), Pisake Lumbiganon, ProfMD (Author), Ganchimeg Togoobaatar, PhD (Author), Shakila Thangaratinam, ProfPhD (Author), Khalid S Khan, ProfMSc (Author)
Format: Book
Published: Elsevier, 2018-05-01T00:00:00Z.
Subjects:
Online Access:Connect to this object online.
Tags: Add Tag
No Tags, Be the first to tag this record!

MARC

LEADER 00000 am a22000003u 4500
001 doaj_38427ffed0cb47ce8b7cc8b858a5ebb6
042 |a dc 
100 1 0 |a Jahnavi Daru, MBBS  |e author 
700 1 0 |a Javier Zamora, ProfPhD  |e author 
700 1 0 |a Borja M Fernández-Félix, MSc  |e author 
700 1 0 |a Joshua Vogel, PhD  |e author 
700 1 0 |a Olufemi T Oladapo, FWACS  |e author 
700 1 0 |a Naho Morisaki, PhD  |e author 
700 1 0 |a Özge Tunçalp, PhD  |e author 
700 1 0 |a Maria Regina Torloni, PhD  |e author 
700 1 0 |a Suneeta Mittal, MD  |e author 
700 1 0 |a Kapila Jayaratne, MD  |e author 
700 1 0 |a Pisake Lumbiganon, ProfMD  |e author 
700 1 0 |a Ganchimeg Togoobaatar, PhD  |e author 
700 1 0 |a Shakila Thangaratinam, ProfPhD  |e author 
700 1 0 |a Khalid S Khan, ProfMSc  |e author 
245 0 0 |a Risk of maternal mortality in women with severe anaemia during pregnancy and post partum: a multilevel analysis 
260 |b Elsevier,   |c 2018-05-01T00:00:00Z. 
500 |a 2214-109X 
500 |a 10.1016/S2214-109X(18)30078-0 
520 |a Summary: Background: Anaemia affects as many as half of all pregnant women in low-income and middle-income countries, but the burden of disease and associated maternal mortality are not robustly quantified. We aimed to assess the association between severe anaemia and maternal death with data from the WHO Multicountry Survey on maternal and newborn health. Methods: We used multilevel and propensity score regression analyses to establish the relation between severe anaemia and maternal death in 359 health facilities in 29 countries across Latin America, Africa, the Western Pacific, eastern Mediterranean, and southeast Asia. Severe anaemia was defined as antenatal or postnatal haemoglobin concentrations of less than 70 g/L in a blood sample obtained before death. Maternal death was defined as death any time after admission until the seventh day post partum or discharge. In regression analyses, we adjusted for post-partum haemorrhage, general anaesthesia, admission to intensive care, sepsis, pre-eclampsia or eclampsia, thrombocytopenia, shock, massive transfusion, severe oliguria, failure to form clots, and severe acidosis as confounding variables. These variables were used to develop the propensity score. Findings: 312 281 women admitted in labour or with ectopic pregnancies were included in the adjusted multilevel logistic analysis, and 12 470 were included in the propensity score regression analysis. The adjusted odds ratio for maternal death in women with severe anaemia compared with those without severe anaemia was 2·36 (95% CI 1·60-3·48). In the propensity score analysis, severe anaemia was also associated with maternal death (adjusted odds ratio 1·86 [95% CI 1·39-2·49]). Interpretation: Prevention and treatment of anaemia during pregnancy and post partum should remain a global public health and research priority. Funding: Barts and the London Charity. 
546 |a EN 
690 |a Public aspects of medicine 
690 |a RA1-1270 
655 7 |a article  |2 local 
786 0 |n The Lancet Global Health, Vol 6, Iss 5, Pp e548-e554 (2018) 
787 0 |n http://www.sciencedirect.com/science/article/pii/S2214109X18300780 
787 0 |n https://doaj.org/toc/2214-109X 
856 4 1 |u https://doaj.org/article/38427ffed0cb47ce8b7cc8b858a5ebb6  |z Connect to this object online.