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

Table 3

Distribution of cases of severe maternal morbidity according to the group of severity, main causes of morbidity, and level of performance of care.

	Level of performance of care				𝑃^1
	Adequate		Nonadequate
	𝑛	(%)	𝑛	(%)
Outcome of severity^&					0.4
PLTC	5,543	(90.8)	3,102	(89.9)
MNM	494	(8.1)	276	(8.0)
MD	66	(1.1)	74	(2.1)
Total	6,103	(100.0)	3,452	(100.0)
Main causes
Hemorrhage	1,438	(23.6)	840	(24.3)	0.92
Hypertension	4,323	(70.8)	2,383	(69.0)	0.83
Infection	83	(1.4)	17	(0.5)	0.04
Clinical-surgical	614	(10.1)	409	(11.8)	0.5
Total	6,103		3,452
Maternal health indicators
MNMR	10/1000 LB		8.4/1000 LB		0.89
MMR	134/100.000 LB		225/100.000 LB		<0.001
SMOR	11.4/1000 LB		10.6/1000 LB		0.13
LB	49.275		32.869

LB: live births; MD: maternal death; MMR: maternal mortality ratio; MNM: maternal near miss; PLTC: potentially life-threatening condition; SMOR: severe maternal outcome ratio.
^&Comparisons: PLTC × (NM + MD): 𝑃=0.721; (PLTC + NM) × MD: 𝑃=0.123.
¹𝑃 value adjusted for cluster effect.