{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T14:57:00Z","timestamp":1787065020794,"version":"build-2736575974"},"reference-count":21,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2019,1,24]],"date-time":"2019-01-24T00:00:00Z","timestamp":1548288000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["1\u2010D43\u2010TW\u2010009353\u201001"],"award-info":[{"award-number":["1\u2010D43\u2010TW\u2010009353\u201001"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2019,5]]},"abstract":"\n Objective<\/jats:title>\n To explore the incidence and factors associated with maternal near\u2010miss.<\/jats:p>\n <\/jats:sec>\n \n Design<\/jats:title>\n Cross\u2010sectional study with an embedded case\u2013control study.<\/jats:p>\n <\/jats:sec>\n \n Setting<\/jats:title>\n Three tertiary referral hospitals in southern Ghana.<\/jats:p>\n <\/jats:sec>\n \n Population<\/jats:title>\n All women admitted to study facilities with pregnancy\u2010related complications or for birth.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n An adapted version of the\n WHO<\/jats:styled-content>\n Maternal Near Miss Screening Tool was used to identify maternal near\u2010miss cases. These were compared with unmatched controls (uncomplicated deliveries) in a ratio of 1:2.\n <\/jats:p>\n <\/jats:sec>\n \n Main outcome measures<\/jats:title>\n Incidence of maternal near\u2010miss, maternal near\u2010miss to maternal mortality ratio, and cause of and factors associated with maternal near\u2010miss.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Out of 8433 live births, 288 maternal near\u2010miss cases and 62 maternal deaths were identified. In all, 454 healthy controls were recruited for comparison. Maternal near\u2010miss and maternal death incidence ratios were 34.2 (95%\n CI<\/jats:styled-content>\n 30.2\u201338.1) and 7.4 (95%\n CI<\/jats:styled-content>\n 5.5\u20139.2) per 1000 live births, respectively with a maternal near\u2010miss to mortality ratio of 4.6:1. Cause of near\u2010miss was pre\u2010eclampsia\/eclampsia (41.0%), haemorrhage (12.2%), maternal sepsis (11.1%) and ruptured uterus (4.2%). A major factor associated with maternal near\u2010miss was maternal fever within the 7\u00a0days before birth (\n OR<\/jats:styled-content>\n 5.95, 95%\n CI<\/jats:styled-content>\n 3.754\u20139.424). Spontaneous onset of labour was protective against near\u2010miss (\n OR<\/jats:styled-content>\n 0.09 95%\n CI<\/jats:styled-content>\n 0.057\u20130.141).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n For every maternal death, there were nearly five maternal near\u2010misses. Women having a fever in the 7\u00a0days before delivery were six times more likely to experience a near\u2010miss than women not having fever.<\/jats:p>\n <\/jats:sec>\n \n Tweetable abstract<\/jats:title>\n Maternal near\u2010miss exceeds maternal death by 5:1, with the leading cause of maternal near\u2010miss was pre\u2010eclampsia\/eclampsia.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/1471-0528.15578","type":"journal-article","created":{"date-parts":[[2018,12,12]],"date-time":"2018-12-12T09:25:08Z","timestamp":1544606708000},"page":"755-762","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":37,"title":["Incidence, causes and correlates of maternal near\u2010miss morbidity: a multi\u2010centre cross\u2010sectional study"],"prefix":"10.1111","volume":"126","author":[{"given":"SA","family":"Oppong","sequence":"first","affiliation":[{"name":"School of Medicine and Dentistry University of Ghana Accra Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Bakari","sequence":"additional","affiliation":[{"name":"Suntresu Government Hospital Ghana Health Service Kumasi Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"AJ","family":"Bell","sequence":"additional","affiliation":[{"name":"University of Michigan Ann Arbor MI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Y","family":"Bockarie","sequence":"additional","affiliation":[{"name":"Cape Coast Teaching Hospital Cape Coast Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"JA","family":"Adu","sequence":"additional","affiliation":[{"name":"School of Medical Sciences University of Cape Coast Cape Coast Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"CA","family":"Turpin","sequence":"additional","affiliation":[{"name":"School of Medical Sciences Kwame Nkrumah University of Science and Technology Kumasi Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"SA","family":"Obed","sequence":"additional","affiliation":[{"name":"School of Medicine and Dentistry University of Ghana Accra Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"RM","family":"Adanu","sequence":"additional","affiliation":[{"name":"School of Public Health University of Ghana Accra Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"CA","family":"Moyer","sequence":"additional","affiliation":[{"name":"University of Michigan Ann Arbor MI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,1,24]]},"reference":[{"key":"e_1_2_6_2_1","unstructured":"World Health Organization.Trends in Maternal Mortality 1990\u20132013. 2014 [http:\/\/apps.who.int\/iris\/bitstream\/10665\/112682\/2\/9789241507226_eng.pdf?ua=1] Accessed 29 September 2017."},{"key":"e_1_2_6_3_1","unstructured":"WHO UNICEF UNFPA The World Bank.Trends in Maternal Mortality: 1990\u20132008. [http:\/\/whqlibdoc.who.int\/publications\/2010\/9789241500265_eng.pdf]. Published 2010. Accessed 12 August 2017."},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/1742-4755-6-7"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2013.05.017"},{"key":"e_1_2_6_6_1","first-page":"105","article-title":"Trends in maternal mortality in Tamale Teaching hospital","volume":"45","author":"Gumanga SK","year":"2011","journal-title":"Ghana Med J"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-11-159"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2013.06.003"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0044536"},{"key":"e_1_2_6_10_1","unstructured":"WHO.Beyond the numbers: Reviewing maternal deaths and complications to make pregnancy safer. [http:\/\/www.who.int\/maternal_child_adolescent\/documents\/9241591838\/en\/]. Accessed 12 August 2017."},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2012.03294.x"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpobgyn.2009.01.007"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2393-11-65"},{"key":"e_1_2_6_14_1","unstructured":"Ghana Statistical Service.2010 Population and Housing Census."},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0044129"},{"key":"e_1_2_6_16_1","first-page":"68","volume-title":"The WHO Application of ICD\u201010 to Deaths During Pregnancy, Childbirth and the Puerperium, IDC MM","author":"World Health Organization","year":"2012"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)60696-6"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1155\/2013\/393758"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-016-1051-4"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-016-0811-5"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2016.05.009"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12978-016-0232-y"}],"container-title":["BJOG: An International Journal of Obstetrics & Gynaecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2F1471-0528.15578","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1471-0528.15578","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/1471-0528.15578","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1471-0528.15578","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,4]],"date-time":"2023-09-04T09:23:15Z","timestamp":1693819395000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/1471-0528.15578"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,1,24]]},"references-count":21,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2019,5]]}},"alternative-id":["10.1111\/1471-0528.15578"],"URL":"https:\/\/doi.org\/10.1111\/1471-0528.15578","archive":["Portico"],"relation":{},"ISSN":["1470-0328","1471-0528"],"issn-type":[{"value":"1470-0328","type":"print"},{"value":"1471-0528","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,1,24]]},"assertion":[{"value":"2018-11-25","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-01-24","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}