A scoping review of maternal near miss assessment in Australia, New Zealand, South-East Asia and the South Pacific region: how, what, why and where to?

Jayaratnam, Skandarupan, Franklin, Richard, and de Costa, Caroline (2022) A scoping review of maternal near miss assessment in Australia, New Zealand, South-East Asia and the South Pacific region: how, what, why and where to? Australian and New Zealand Journal of Obstetrics and Gynaecology, 62 (2). pp. 198-213.

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Abstract

Background Severe maternal morbidity or maternal near miss (MNM) events can have significant consequences for individuals, their families and society and the study of these events may inform practices to reduce future adverse pregnancy outcomes.

Aims To review the scope of MNM studies undertaken in Australia, New Zealand, South-East Asia and the South Pacific region. Materials and Methods A systematic search of four online databases (MEDLINE, EMBASE, SCOPUS and CINAHL) and the World Health Organization Library was conducted to identify all relevant studies published between 1 January 2011 and 31 December 2020. The studies were reviewed and included if they assessed MNM using a composite outcome or a predefined set of indicators.

Results The literature search yielded 143 articles of which 49 are included in this review. There were substantial differences in the monitoring approach to MNM in the Australasian region. Overall rates of MNM in the region ranged from two to 100/1000 births and the most common aetiologies identified were direct obstetric causes such as postpartum haemorrhage, pre-eclampsia and sepsis. Multidisciplinary review indicated a substantial number of MNM cases were preventable or amenable to improved management, mostly from a provider perspective.

Conclusions Assessment of MNM is an important part of the evaluation of maternity care provision. Reaching a consensus on indicators and how best to collect information will allow a more discerning assessment of MNM including longer-term health outcomes, aspects of preventability and financial implications for health services.

Item ID: 72584
Item Type: Article (Research - C1)
ISSN: 0004-8666
Keywords: health care,maternal complications,maternal health,near miss,severe maternal morbidity,severe maternal outcomes
Copyright Information: © 2021 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists
Date Deposited: 23 Feb 2022 08:07
FoR Codes: 42 HEALTH SCIENCES > 4203 Health services and systems > 420311 Health systems @ 100%
SEO Codes: 20 HEALTH > 2002 Evaluation of health and support services > 200202 Evaluation of health outcomes @ 100%
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