Predictors of maternal mortality and near-miss maternal morbidity

Objective: To identify risk factors for life- threatening maternal outcomes. Study Design: Hospital charts were reviewed for cases of maternal mortality or near- miss and for controls overmatched 1: 3. Significant risk factors were identified through simple and best subsets multiple logistic regression. Result: Eight cases of mortality and 69 near- miss cases were found. Significant risk factors with their odds ratios and 95% confidence intervals are: age 35 to 39 years ( 2.3, 1.2 to 4.4) and > 39 years ( 5.1, 1.8 to 14.4); African- American race ( 7.4, 2.5 to 22.0) and Hispanic ethnicity ( 4.2, 1.3 to 13.2); chronic medical condition ( 2.7, 1.5 to 4.8); obesity ( 3.0, 1.7 to 5.3); prior cesarean ( 5.2, 2.8 to 9.8) and gravidity ( 1.2, 1.1 to 1.5 per pregnancy). In multivariable logistic regression, race remained significant while controlling for other significant factors and markers of socioeconomic status. Conclusion: Some risk factors can be modified through medical care, education or social support systems. Racial disparity in outcome is confirmed and is unexplained by traditional risk factors.