The multidimensional impact of maternal near-miss on the lives of women in Zanzibar, Tanzania: a prospective, 1-year follow-up study.

Journal: AJOG global reports

Volume: 3

Issue: 2

Year of Publication: 

Affiliated Institutions:  Department of Obstetrics and Gynaecology, Erasmus University Medical Center, University Medical Centre Rotterdam, Rotterdam, The Netherlands (Drs Herklots, Franx, and Koster). Department of Obstetrics and Gynaecology, Hospital Gelderse Vallei, Ede, The Netherlands (Dr Bron). Department of Obstetrics and Gynaecology, Mnazi Mmoja Hospital, Zanzibar, United Republic of Tanzania (Mses Mbarouk and Mzee). Department of Obstetrics, University Medical Centre Utrecht, Utrecht, The Netherlands (Dr Lamers). Department of Obstetrics and Gynaecology, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands (Dr Meguid). Department of Obstetrics and Gynaecology, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands (Dr Jacod).

Abstract summary 

Severe maternal morbidity has been shown to have specific, long-term effects on health and wellbeing, such as daily functioning and mental health.This study aimed to multidimensionally assess the long-term impact of maternal near-miss complications in Zanzibar.A prospective cohort study was conducted in Zanzibar's referral hospital. Women with maternal near-miss complications were matched with controls. At 3, 6, and 12 months after hospital discharge, history was taken, blood pressure and haemoglobin levels were measured, and multiple validated questionnaires (WHOQOL-BREF, WHODAS2.0, Patient Health Questionnaire-9, Harvard Trauma Questionnaire-16) were administered assessing experienced quality of life and disability, and screening for depression and posttraumatic stress disorder.We included 223 women after maternal near-miss complications and 213 women controls. There was a high prevalence of hypertension at 6 and 12 months in both groups and significantly higher after a near-miss. The proportion of women with low quality of life, disability, depression, or posttraumatic stress disorder was not significantly different between the 2 groups. A poor outcome for at least 1 of these 3 health domains was more prevalent after a near-miss complication.In Zanzibar, women after maternal near-miss complications report similar but slower recovery to control participants in the assessed dimensions. Adaptation of perceptions on and coping mechanisms with daily reality might partly explain this. Hypertension has a high prevalence after childbirth and should be treated adequately to prevent recurrent obstetrical and cardiovascular complications. Blood pressure follow-up for all women who delivered at Mnazi Mmoja Hospital seemed justified.

Authors & Co-authors:  Herklots Tanneke T Bron Vreni V Mbarouk Shadya Saidun SS Mzee Maryam Khamis MK Lamers Evert E Meguid Tarek T Franx Arie A Koster Maria P H MPH Jacod Benoit B

Study Outcome 

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Citations :  Filippi V, Ronsmans C, Campbell OM, et al. Maternal health in poor countries: the broader context and a call for action. Lancet. 2006;368:1535–1541.
Authors :  9
Identifiers
Doi : 100199
SSN : 2666-5778
Study Population
Women
Mesh Terms
Other Terms
Tanzania;Zanzibar;long-term outcomes;low-income setting;maternal morbidity;near-miss;post-partum
Study Design
Cohort Study
Study Approach
Country of Study
Tanzania
Publication Country
United States