Severe maternal morbidity in high income countries
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Published Version
Date
2021
Authors
Kaskun, Oleksandra
Journal Title
Journal ISSN
Volume Title
Publisher
UCC Medical Research and Technology Society
Published Version
Abstract
Introduction: With declining maternal mortality rates in high income countries (HICs), severe maternal morbidity (SMM) is becoming an important quality measure of maternal care. However, there is no international consensus on the definition and types of SMM. This study aims to critically analyze published literature on SMM in HICs. Objectives: To compare definitions and criteria used to identify SMM, and to identify the main types and risk factors contributing to SMM in eight HICs. Methods: Three databases were searched, results were filtered, and ten studies were critically appraised. Results: Six of the articles discussed SMM identification criteria and proposed definition modifications. Longer hospital stay and admission to intensive care unit were suggested as additional criteria. Disease-based criteria was shown to be superior to organ dysfunction criteria. Seven articles detailed common types of SMM as severe haemorrhage, hypertensive disorders, and pre-eclampsia/eclampsia. Six articles described SMM risk factors, of which advanced maternal age and caesarean delivery were most common. Discussion: This literature review identified disease-based criteria and Canadian study criteria as promising measures of SMM. It also identified several types and risk factors of SMM common between HICs. These findings can help physicians identify women at risk of SMM. The study is however limited to eight HICs and ten studies. Further research should aim to investigate how the measures compare with previous sources of criteria, and to discern the association of weight and race risk factors with SMM.
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Keywords
Maternal morbidity
Citation
Kaskun, O. (2021) 'Severe maternal morbidity in high income countries', UCC Student Medical Journal, Vol. 2, pp. 1-14. https://doi.org/10.33178/SMJ.2021.1.1