Infection-related severe maternal outcomes and case fatality rates in 43 low and middle-income countries across the WHO regions

Results from the Global Maternal Sepsis Study (GLOSS)

Bibliographic Data

ID19591985
AuthorsAdama Baguiya (0000-0003-1016-4896, Institut de Recherche en Sciences de la Santé, corresponding author), Mercedes Bonet (0000-0001-9015-1635, World Health Organization, corresponding author), Vanessa Brizuela (0000-0002-4860-0828, World Health Organization, corresponding author), Cristina Cuesta (0000-0002-6127-5601, National University of Rosario, corresponding author), Marian Knight (0000-0002-1984-4575, University of Oxford, corresponding author), Pisake Lumbiganon (0000-0001-9372-0071, Khon Kaen University, corresponding author), Edgardo Abalos (0000-0001-6653-429X, Centro Rosarino de Estudios Perinatales, corresponding author), Seni Kouanda (0000-0003-2426-7669, Institut de Recherche en Sciences de la Santé, corresponding author)
EditorsHannah Tappis (0000-0002-4289-5418)
Year2024
Volume4
Issue4
Pagese0003109
Publication date2024-04-25
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenuePLOS Global Public Health (JOURNAL)
Journal identifiersISSN: 2767-3375 • E-ISSN: 2767-3375
PublisherPublic Library of Science (PLoS) (PUBLISHER)
DOI10.1371/journal.pgph.0003109
PMID38662723
OpenAlexW4395448077
LanguageEN
References cited28

The highest toll of maternal mortality due to infections is reported in low and middle-income countries (LMICs). However, more evidence is needed to understand the differences in infection-related severe maternal outcomes (SMO) and fatality rates across the WHO regions. This study aimed to compare the burden of infection-related SMO and case fatality rates across the WHO regions using the Global Maternal Sepsis Study (GLOSS) data. GLOSS was a hospital-based one-week inception prospective cohort study of pregnant or recently pregnant women admitted with suspected or confirmed infection in 2017. Four hundred and eight (408) hospitals from 43 LMICs in the six WHO regions were considered in this analysis. We used a logistic regression model to compare the odds of infection-related SMOs by region. We then calculated the fatality rate as the proportion of deaths over the total number of SMOs, defined as maternal deaths and near-misses. The proportion of SMO was 19.6% (n = 141) in Africa, compared to 18%(n = 22), 15.9%(n = 50), 14.7%(n = 48), 12.1%(n = 95), and 10.8%(n = 21) in the Western Pacific, European, Eastern Meditteranean, Americas, and South-Eastern Asian regions, respectively. Women in Africa were more likely to experience SMO than those in the Americas (aOR = 2.41, 95%CI: [1.78 to 2.83]), in South-East Asia (aOR = 2.60, 95%CI: [1.57 to 4.32]), and the Eastern Mediterranean region (aOR = 1.58, 95%CI: [1.08 to 2.32]). The case fatality rate was 14.3%[3.05% to 36.34%] (n/N = 3/21) and 11.4%[6.63% to 17.77%] (n/N = 16/141) in the South-East Asia and Africa, respectively. Infection-related SMOs and case fatality rates were highest in Africa and Southeast Asia. Specific attention and actions are needed to prevent infection-related maternal deaths and severe morbidity in these two regions

Biology · Case fatality rate · Developing country · Logistic regression · Low and middle income countries · Odds ratio · Prospective cohort study · Demography · Global Maternal and Child Health · Maternal and fetal healthcare · Medicine · Sepsis Diagnosis and Treatment · Epidemiology · Internal Medicine