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BioMed Research International
Volume 2017, Article ID 8271042, 12 pages
Research Article

Exploring the Concept of Degrees of Maternal Morbidity as a Tool for Surveillance of Maternal Health in Latin American and Caribbean Settings

1Latin American Centre of Perinatology (CLAP-WR/FGL-PAHO), Montevideo, Uruguay
2Pan American Health Organization (PAHO/FGL), Washington, DC, USA
3World Health Organization (WHO), RHR/HRP, Geneva, Switzerland
4Department of Obstetrics and Gynecology, University of Campinas, Campinas, SP, Brazil

Correspondence should be addressed to Jose G. Cecatti; rb.pmacinu@ittacec

Received 2 April 2017; Revised 12 June 2017; Accepted 14 September 2017; Published 22 October 2017

Academic Editor: Andrea Tinelli

Copyright © 2017 Suzanne J. Serruya et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Objectives. To assess a birth registry to explore maternal mortality and morbidity and their association with other factors. Study Design. Exploratory multicentre cross-sectional analysis with over 700 thousand childbirths from twelve Latin American and Caribbean countries between 2009 and 2012. The WHO criteria for maternal morbidity were employed to split women, following a gradient of severity of conditions, into (1) maternal death (MD); (2) maternal near miss (MNM); (3) potentially life-threatening conditions (PLTC); (4) less severe maternal morbidity (LSMM); (5) any maternal morbidity; and (6) women with no maternal morbidity. Their prevalence and estimated risks of adverse maternal outcomes were assessed. Results. 712,081 childbirths had a prevalence of MD and MNM of 0.14% and 3.1%, respectively, while 38% of women had experienced morbidity. Previous maternal morbidity was associated with higher risk of adverse maternal outcomes and also the extremes of reproductive ages, nonwhite ethnicity, no stable partner, no prenatal care, smoking, drug and alcohol use, elective C-section, or induction of labour. Poorer perinatal outcomes were proportional to the severity of maternal outcomes. Conclusions. The findings corroborate WHO concept regarding continuum of maternal morbidity, reinforcing its importance in preventing adverse maternal outcomes and improving maternal healthcare in different settings.