Applying the Maternal Near Miss Approach for the Evaluation of Quality of Obstetric Care: A Worked Example from a Multicenter Surveillance Study

Table 2

Analyses of MSI, SMR, and level of performance for each center of the Brazilian Network for Surveillance of Severe Maternal Morbidity.

Center	MSI (%)	Observed number of deaths	Sample size	Expected deaths	SMR	(95% CI)	Performance
1	0.44%	5	566	2	2.01	(0.65–4.69)	Non A
2	3.54%	4	96	3	1.18	(0.32–3.01)	A
3	0.57%	0	253	1	0.00	(0.00–2.56)	A
4	7.74%	6	112	9	0.69	(0.25–1.51)	A
5	1.92%	2	210	4	0.50	(0.06–1.79)	A
6	1.93%	17	1086	21	0.81	(0.47–1.30)	A
7	1.81%	3	172	3	0.96	(0.20–2.82)	A
8	0.25%	1	1050	3	0.38	(0.01–2.12)	A
9	1.40%	4	155	2	1.84	(0.50–4.72)	Non A
10	3.84%	30	609	23	1.28	(0.87–1.83)	Non A
11	0.68%	3	186	1	2.37	(0.49–6.93)	Non A
12	7.91%	8	98	8	1.03	(0.45–2.03)	A
13	4.55%	3	154	7	0.43	(0.09–1.25)	A
14	0.59%	0	841	5	0.00	(0.00–0.74)	A
15	3.24%	9	369	12	0.75	(0.34–1.43)	A
16	1.04%	11	945	10	1.12	(0.56–2.00)	A
17	1.15%	5	294	3	1.48	(0.48–3.45)	Non A
18	1.39%	1	66	1	1.09	(0.03–6.08)	A
19	0.69%	8	920	6	1.26	(0.54–2.48)	Non A
20	4.05%	8	118	5	1.67	(0.72–3.30)	Non A
21	0.53%	0	48	0	0.00	(0.0–14.52)	A
22	3.25%	5	74	2	2.08	(0.68–4.85)	Non A
23	0.47%	3	465	2	1.37	(0.28–4.01)	Non A
24	0.49%	1	263	1	0.78	(0.02–4.32)	A
25	1.66%	3	65	1	2.78	(0.57–8.12)	Non A
26	0.05%	0	59	0	0.00	(0.0–122.9)	A
27	0.11%	0	281	0	0.00	(0.0–11.93)	A
Overall	1.44%	140	9555	138	1.02	(0.86–1.20)	A

A: adequate; Non A: nonadequate; MSI: maternal severity index; SMR: standardized mortality ratio.