Standardizing the measurement of maternal morbidity: Pilot study results

Journal Article
(Published June, 2018)
Barreix, M. (Author),
Barbour, K. (Author),
McCaw-Binns, A. (Author),
Chou, D. (Author),
Petzold, M. (Author),
Gochuhi, Gathari (Author)
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A cross-sectional field test of a standardized instrument to measure nonsevere morbidity among antenatal and postpartum women 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.


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Barreix M, Barbour K, McCaw-Binns A, Chou D, Petzold M, Gichuhi GN, et al. 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. 2018;141 Suppl 1:10-9