Table 4.
Relationship between mode of delivery and severe maternal outcomes by continent
| Severe Maternal Outcomes | No (%) | Adjusted OR [95%CI] |
|---|---|---|
| Africa † | ||
| Spontaneous (reference) | 1011/69,364 (1.46) | 1 to |
| Operative | 151/2,298 (6.57) | 2.58 (2.12-3.15) |
| Antepartum without indications | 14/63(22.22) | 71.29 (32.06 to 158.55) |
| Intrapartum without indications | 36/202(17.82) | 40.67 (24.56-67.33) |
| Antepartum with indications | 960/2,399(40.02) | 88.61 (74.88 to 104.86) |
| Intrapartum with indications | 1,942/7,396(26.26) | 54.26 (47.81 to 61.59) |
| Americas†† | ||
| Spontaneous (reference) | 946/61130 (1.55) | 1 |
| Operative | 50/1533 (3.26) | 2.2 (1.62 to 2.99) |
| Antepartum without indications | 6/157(3.82) | 1.94 (0.77 to 4.9) |
| Intrapartum without indications | 10/194(5.15) | 4 (2.05 to 7.82) |
| Antepartum with indications | 803/13759(5.84) | 3.04 (2.71 to 3.41) |
| Intrapartum with indications | 640/20120(3.18) | 1.91 (1.71 to 2.13) |
| Asia††† | ||
| Spontaneous (reference) | 1190/75057 (1.59) | 1 |
| Operative | 145/3465 (4.18) | 1.91 (1.56 to 2.35) |
| Antepartum without indications | 8/1515(0.53) | 2.14 (1.04 to 4.43) |
| Intrapartum without indications | 40/554(7.22) | 12.86 (8.83 to 18.73) |
| Antepartum with indications | 689/10853(6.35) | 8.09 (7.12 to 9.18) |
| Intrapartum with indications | 1941/16506(11.76) | 11.61 (10.56 to 12.76) |
†Maternal age, Total number of years attended school, Primiparaous, Birth weight, Neonatal death or stillbirth, Caesarean section at last pregnancy, Pregnancy induced hypertension or preeclampsia or eclampsia or chronic hypertension, Suspected fetal growth impairment, Vaginal bleeding in 2nd half of pregnancy, Referred for complication related to pregnancy or delivery, Any other medical complication during pregnancy (excluding chronic hypertension), Country, Incentive for caesarean section
††Birth weight, Prelabour rupture of membranes, Pregnancy induced hypertension or preeclampsia or eclampsia or chronic hypertension, Vaginal bleeding in 2nd half of pregnancy, Any antenatal antibiotic treatment, Referred for complication related to pregnancy or delivery, Induced labour, HIVPOS, Any other medical complication during pregnancy (excluding chronic hypertension) and Incentive for caesarean section
††† Maternal age, Total number of years attended school, Primiparous, Birth weight, Neonatal death or stillbirth, Prelabour rupture of membranes, Pregnancy induced hypertension or preeclampsia or eclampsia or chronic hypertension, Vaginal bleeding in 2nd half of pregnancy, Breech or other non-cephalic precentation, Referred for complication related to pregnancy or delivery, HIVPOS, Any other medical complication during pregnancy (excluding chronic hypertension), Country and Complexity of index
(Differently from the previous Asian specific analysis [7], the severe maternal outcomes included in this analysis are: death, admission to ICU, blood transfusion and hysterectomy)