Obstetric near-miss cases among women admitted to intensive care units in Italy

Acta Obstet Gynecol Scand. 2012 Apr;91(4):452-7. doi: 10.1111/j.1600-0412.2012.01352.x. Epub 2012 Feb 22.


Objective: Maternal near-miss defines a narrow category of morbidity encompassing potentially life-threatening episodes. The purpose of this study was to detect near-miss instances among women admitted to intensive care units or coronary units, analyze associated causes, and compute absolute and specific maternal morbidity rates in six Italian regions.

Design: Observational retrospective study.

Setting: Six Italian regions representing 49% of all resident Italian women aged 15-49 years.

Population: The study population included all pregnant women aged 15-49 years admitted to intensive care units or coronary care units in the participating regions. Cases were defined as women aged 15-49 years resident in the participating regions, with one or more hospitalizations in intensive care for pregnancy or any pregnancy outcome between 2004 and 2005.

Methods: Cases were identified through the Hospital Discharge Database. Enrolled cases were diagnosed according to the 9(th) International Classification of Diseases.

Main outcome measure: Maternal near-miss rate (number of women experiencing an admission to intensive care units/all women with live or stillborn babies).

Results: A total of 1259 near-miss cases were identified and the total maternal near-miss rate was 2.0/1000 deliveries. Seventy percent of the women were admitted to intensive care units or coronary units after a cesarean section. The leading associated risk factors were obstetric hemorrhage/disseminated intravascular coagulation (40%) and hypertensive disorders of pregnancy (29%).

Conclusions: Monitoring of near-miss morbidity in conjunction with mortality surveillance could help to identify effective preventive measures for potentially life-threatening episodes.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Abortion, Induced
  • Adolescent
  • Adult
  • Critical Illness / epidemiology*
  • Emergencies / epidemiology*
  • Female
  • Hospitalization / statistics & numerical data*
  • Humans
  • Intensive Care Units / statistics & numerical data
  • Italy / epidemiology
  • Maternal Mortality
  • Middle Aged
  • Postoperative Complications / epidemiology
  • Postoperative Complications / prevention & control
  • Pregnancy
  • Pregnancy Complications / epidemiology*
  • Pregnancy Complications / prevention & control
  • Retrospective Studies
  • Risk
  • Risk Factors
  • Young Adult