Standardizing the measurement of maternal morbidity: Pilot study results.

Barreix, Maria; Barbour, Kelli; McCaw-Binns, Affette; Chou, Doris; Petzold, Max; Gichuhi, Gathari N; Gadama, Luis; Taulo, Frank; Tunçalp, Özge; Say, Lale; +1 more... WHO Maternal Morbidity Working Group (MMWG); (2018) Standardizing the measurement of maternal morbidity: Pilot study results. International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics, 141 Su (Suppl ). pp. 10-19. ISSN 0020-7292 DOI: https://doi.org/10.1002/ijgo.12464

Abstract

OBJECTIVE: To field test a standardized instrument to measure nonsevere morbidity among antenatal and postpartum women. METHODS: A cross-sectional study was conducted in Jamaica, Kenya, and Malawi (2015-2016). Women presenting for antenatal care (ANC) or postpartum care (PPC) were recruited if they were at least 28 weeks into pregnancy or 6 weeks after delivery. They were interviewed and examined by a doctor, midwife, or nurse. Data were collected and securely stored electronically on a WHO server. Diagnosed conditions were coded and summarized using ICD-MM. RESULTS: A total of 1490 women (750 ANC; 740 PPC) averaging 26 years of age participated. Most women (61.6% ANC, 79.1% PPC) were healthy (no diagnosed medical or obstetric conditions). Among ANC women with clinical diagnoses, 18.3% had direct (obstetric) conditions and 18.0% indirect (medical) problems. Prevalences among PPC women were lower (12.7% and 8.6%, respectively). When screening for factors in the expanded morbidity definition, 12.8% (ANC) and 11.0% (PPC) self-reported exposure to violence. CONCLUSION: Nonsevere conditions are distinct from the leading causes of maternal death and may vary across pregnancy and the puerperium. This effort to identify and measure nonsevere morbidity promotes a comprehensive understanding of morbidity, incorporating maternal self-reporting of exposure to violence, and mental health. Further validation is needed.