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Morka W, Megersa G, Bekele E, Deksisa A. Incidence of Adverse Perinatal Outcomes among Women Exposed to Maternal Near-Misses in Arsi Zone in Ethiopia: Prospective Cohort Study in 2022. J Pregnancy 2024; 2024:6560652. [PMID: 38550878 PMCID: PMC10978081 DOI: 10.1155/2024/6560652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 12/30/2023] [Accepted: 02/29/2024] [Indexed: 04/02/2024] Open
Abstract
Background Exposure to maternal near-misses has a massive effect on adverse perinatal outcomes. Hence, investigating the effect of maternal near-misses on perinatal outcomes can aid in the reduction of perinatal morbidity and mortality. The study is aimed at assessing the incidence of adverse perinatal outcomes among women exposed to maternal near-misses at Arsi Zone public hospitals in Ethiopia in 2022. Method The study included a prospective cohort of 335 women at Arsi Zone public hospitals from December 2021 to June 2022. Women who were admitted for management of pregnancy were followed. The exposed group was women with maternal near-misses screened based on disease-validated criteria. The nonexposed group was made up of women who delivered without complications. Trained data collectors used pretested, structured questionnaires to collect data from women. Pertinent data was also extracted from the clients' logbooks. Data was transferred from EpiData version 3.1 to SPSS version 25 for analysis, logistic regression was computed, and 95% confidence intervals were declared at a p value of 5% significance level. Result The incidence of adverse perinatal outcomes was higher in the exposed women than in the nonexposed women (56% versus 16%). Contrasted with the nonexposed, women exposed to maternal near-misses had a higher incidence of stillbirth (22% vs. 0.5%), low birth weight (13% vs. 3%), and preterm birth (12% vs. 2%). After adjusting for confounders, exposed women had a twofold increased risk of adverse perinatal outcomes compared to nonexposed women. Delivery mode, delay in seeking care, transport mode, and delay in receiving treatment were the risk factors for negative pregnancy outcomes. Conclusion In exposed women, a higher incidence of adverse perinatal outcomes was linked to aforementioned risk factors. Evidence-based practice intended to decrease delays in providing maternal care services does indeed improve perinatal outcomes.
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Affiliation(s)
- Wogene Morka
- Department of Midwifery, College of Health Sciences, Arsi University, Asella, Ethiopia
| | - Getu Megersa
- Department of Midwifery, College of Health Sciences, Arsi University, Asella, Ethiopia
| | - Elias Bekele
- Department of Midwifery, College of Health Sciences, Arsi University, Asella, Ethiopia
| | - Abdi Deksisa
- Department of Midwifery, College of Health Sciences, Arsi University, Asella, Ethiopia
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Janoudi G, Uzun (Rada) M, Boyd ST, Fell DB, Ray JG, Foster AM, Giffen R, Clifford TJ, Walker MC. Do Case Reports and Case Series Generate Clinical Discoveries About Preeclampsia? A Systematic Review. Int J Womens Health 2023; 15:411-425. [PMID: 36974131 PMCID: PMC10039711 DOI: 10.2147/ijwh.s397680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Accepted: 03/13/2023] [Indexed: 03/29/2023] Open
Abstract
Background Preeclampsia is a leading cause of maternal and perinatal mortality and morbidity. The management of preeclampsia has not changed much in more than two decades, and its aetiology is still not fully understood. Case reports and case series have traditionally been used to communicate new knowledge about existing conditions. Whether this is true for preeclampsia is not known. Objective To determine whether recent case reports or case series have generated new knowledge and clinical discoveries about preeclampsia. Methods A detailed search strategy was developed in consultation with a medical librarian. Two bibliographic databases were searched through Ovid: Embase and MEDLINE. We selected case reports or case series published between 2015 and 2020, comprising pregnant persons diagnosed with hypertensive disorders of pregnancy, including preeclampsia. Two reviewers independently screened all publications. One reviewer extracted data from included studies, while another conducted a quality check of extracted data. We developed a codebook to guide our data extraction and outcomes assessment. The quality of each report was determined based on Joanna Briggs Institute (JBI) critical appraisal checklist for case reports and case series. Results We included 104 case reports and three case series, together comprising 118 pregnancies. A severe presentation or complication of preeclampsia was reported in 81% of pregnancies, and 84% had a positive maternal outcome, free of death or persistent complications. Only 8% of the case reports were deemed to be of high quality, and 53.8% of moderate quality; none of the case series were of high quality. A total of 26 of the 107 publications (24.3%) included a novel clinical discovery as a central theme. Conclusion Over two-thirds of recent case reports and case series about preeclampsia do not appear to present new knowledge or discoveries about preeclampsia, and most are of low quality.
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Affiliation(s)
- Ghayath Janoudi
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
| | | | - Stephanie T Boyd
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Deshayne B Fell
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
- Children’s Hospital of Eastern Ontario (CHEO) Research Institute, Children’s Hospital of Eastern Ontario, Ottawa, ON, Canada
| | - Joel G Ray
- Departments of Medicine, Health Policy Management and Evaluation, and Obstetrics and Gynecology, St Michael’s Hospital, University of Toronto, Toronto, ON, Canada
| | - Angel M Foster
- Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | | | - Tammy J Clifford
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
- Canadian Institute of Health Research, Government of Canada, Ottawa, ON, Canada
| | - Mark C Walker
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
- International and Global Health Office, University of Ottawa, Ottawa, ON, Canada
- Department of Obstetrics and Gynecology, University of Ottawa, Ottawa, ON, Canada
- Department of Obstetrics, Gynecology & Newborn Care, The Ottawa Hospital, Ottawa, ON, Canada
- BORN Ontario, Children’s Hospital of Eastern Ontario, Ottawa, ON, Canada
- Correspondence: Mark C Walker, Clinical Epidemiology Program, Ottawa Hospital Research Institute, Centre for Practice Changing Research, Box 241, 501 Smyth Road, Ottawa, ON, K1H 8L6, Canada, Tel +1 613-798-5555 x76655, Email
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