Table 3.
Variables significantly associated with severe acute maternal morbidity (SAMM) among a Kabul postpartum population in bivariate conditional logistic regression analysis (n=570).
| Variable | SAMM Cases (n=285) |
Control patients (n=285) |
Odds Ratio, 95% CI |
|
|---|---|---|---|---|
| Socioeconomic factors | n (%) | n (%) | ||
| No formal education: | Female | 200 (70.2%) | 180 (63.2%) | 1.4, 1.0 – 2.0 |
| Male | 102 (35.8%) | 76 (26.7%) | 1.6, 1.1 – 2.2 | |
| Television in home | 173 (60.9%) | 212 (75.7%) | 0.5, 0.3 – 0.7 | |
| Residence outside Kabul area | 50 (17.5%) | 33 (11.6%) | 1.6, 1.0 – 2.5 | |
| Obstetric factors (n=544 multigravid participants; n=269 cases and 275 controls): | ||||
| Skilled attendant at last delivery | 141 (52.4%) | 164 (59.6%) | 0.6, 0.4 – 0.9 | |
| Complications in prior pregnancy | 72 (26.8%) | 20 (7.2%) | 4.9, 2.7 – 8.9 | |
| Advised to have no future pregnancies by medical provider | 38 (14.1%) | 9 (3.3%) | 5.7, 2.4 – 13.5 | |
| Total Abortions: | 0 | 186 (69.1%) | 221 (80.4%) | Reference |
| 1 | 57 (21.2%) | 40 (14.5%) | 1.6, 1.0 – 2.5 | |
| 2 | 18 (6.7%) | 11 (4.0%) | 1.8, 0.8 – 4.0 | |
| ≥3 | 8 (3.0%) | 3 (1.1%) | 2.5, 0.6 – 9.5 | |
| Total Stillbirths: 0 1 ≥2 |
0 | 191 (71.0%) | 258 (93.8%) | Reference |
| 1 | 61 (22.7%) | 14 (5.1%) | 7.2, 3.5 - 14.7 | |
| ≥2 | 17 (6.3%) | 3 (1.1%) | 12.1, 3.1 – 47.5 | |
| Child Health Factors (n=430 women with live births prior to index pregnancy; 212 cases and 218 controls): | ||||
| Last child died before age 1 year** | 18 (8.5%) | 3 (1.4%) | 8.0, 1.8 – 34.8 | |
| Health Care Utilization Prior To Parturition & General Health Status: | ||||
| No antenatal care in index pregnancy | 34 (11.9%) | 12 (4.2%) | 2.8, 1.5 – 5.5 | |
| Frequency bedridden prior to pregnancy: Never <1 time/year >1 time/year |
Never | 181 (63.5%) | 206 (72.3%) | Reference |
| <1 time/year | 89 (31.2%) | 66 (23.2%) | 1.5, 1.0 – 2.2 | |
| >1 time/year | 15 (4.6%) | 13 (3.5%) | 1.3, 0.6 – 2.8 | |
| Perceived health status prior to index pregnancy: Always healthy Nearly always healthy Sometimes to never healthy |
Always healthy | 176 (61.7%) | 193 (67.7%) | Reference |
| Nearly always healthy | 87 (30.5%) | 85 (29.8%) | 1.2, 0.8 – 1.7 | |
| Sometimes to never healthy | 7 (7.7%) | 22 (2.5%) | 3.4, 1.4 – 8.0 | |
| Factors reflecting Relationship Dynamics & Pregnancy Valuation: | ||||
| Index pregnancy undesired Female participants Male participants |
Female participants | 147 (50.2%) | 129 (45.3%) | 1.3, 0.9 – 2.0 |
| Male participants | 80 (28.3%) | 51 (18.2%) | 2.0, 1.3 – 3.0 | |
| Prior unplanned pregnancy: | Female participants | 150 (56.4%) | 139 (50.9%) | 1.3, 0.8 – 1.9 |
| Male participants | 40 (14.1%) | 25 (8.9%) | 1.8, 1.0 – 3.1 | |
| Willing to accept any contraceptive method: Female participants Male participants |
Female participants | 69 (24.2%) | 70 (24.6%) | 1.0, 0.7 – 1.5 |
| Male participants | 139 (48.9%) | 165 (57.9%) | 0.6, 0.5 – 0.9 | |
| Number of current wives of male spouse (n=284 case, 280 control responding) | ≥2 | 14 (4.9%) | 2 (0.7%) | 6.5, 1.5 – 28.8 |
| Factors contributing to delay at parturition: | ||||
| Planned home delivery: | Female participants | 114 (40.1%) | 33 (11.6%) | 5.8, 3.5 – 9.7 |
| Male participants | 69 (24.6%) | 8 (2.9%) | 11.0, 4.8 – 25.4 | |
| Presented to Different Health Facility Prior to Hospital of Delivery/Care: | Female participants | 114 (40.0%) | 18 (6.3%) | 9.0, 5.0 – 16.3 |
| Male participants | 85 (29.9%) | 19 (6.8%) | 5.9, 3.3 – 10.7 | |
| Decision-maker to Come to Hospital (female response): | Male spouse | 95 (33.3%) | 141 (49.5%) | 0.5, 0.3 – 0.7 |
| Medical provider | 58 (20.4%) | 13 (4.6%) | 4.8, 2.6 – 8.9 | |
*
Significant discrepancy between male and female report; displaying male report as most conservative estimate.
**
Of 145 case and 151 control participants with any live births prior to index pregnancy.
CI= confidence interval
n=number