{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T20:36:36Z","timestamp":1784234196922,"version":"3.55.0"},"reference-count":29,"publisher":"Wiley","issue":"S3","license":[{"start":{"date-parts":[[2019,3,21]],"date-time":"2019-03-21T00:00:00Z","timestamp":1553126400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100006660","name":"United Nations Fund for Population Activities","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006660","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2019,6]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To evaluate the burden, causes and outcomes of severe non\u2010obstetric maternal complications in Nigerian public tertiary hospitals.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Secondary analysis of a nationwide cross\u2010sectional study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Forty\u2010two tertiary health facilities.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>Women admitted with complications during pregnancy, childbirth or puerperium.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>All cases of severe maternal outcome (<jats:styled-content style=\"fixed-case\">SMO<\/jats:styled-content>: maternal near\u2010miss or maternal death) due to non\u2010obstetric causes were prospectively identified over a 1\u2010year period. Maternal near\u2010miss was defined using organ\u2010system dysfunction (<jats:styled-content style=\"fixed-case\">WHO<\/jats:styled-content>), clinical, or management\u2010based criteria.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>Causes and contributions of non\u2010obstetric complications to <jats:styled-content style=\"fixed-case\">SMO<\/jats:styled-content>; fetal and neonatal outcomes; health service events associated with non\u2010obstetric complications; and mortality index (% of maternal death\/<jats:styled-content style=\"fixed-case\">SMO<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 100\u00a0107 women admitted with complications, 9401 (9.4%) were for non\u2010obstetric causes; and 4.0% (375\/9401) suffered severe non\u2010obstetric complications. Of the 375 cases of severe non\u2010obstetric complications, 48.8% (183\/375) were near\u2010misses and 51.2% (192\/375) were maternal deaths. Severe anaemia unrelated to haemorrhage contributed 61.2% of near\u2010misses and 32.8% of maternal deaths. The highest mortality indices were observed for cancer (91.7%), hepatic diseases (81.8%) and <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">AIDS<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> wasting syndrome (80.4%). Fatality was significantly high with extremes of age and no formal education. Regarding organ dysfunctions, neurological (77.1%) and cardiovascular (75.0%) dysfunctions had the highest mortality indices. Perinatal mortality was 65.9%. Time from diagnosis of severe non\u2010obstetric complications to review by senior medical personnel, and to definitive intervention was &lt;30 minutes in 30.2% and 29.8% of women with SMO, respectively. However, over 240 minutes elapsed between diagnosis and definitive intervention in more than one\u2010third of women with SMO.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Non\u2010obstetric complications are associated with poorer pregnancy outcomes and deserve attention similar to that accorded obstetric complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Funding<\/jats:title><jats:p>The original research that generated the data for this secondary analysis and the publication of this secondary analysis were funded by the <jats:styled-content style=\"fixed-case\">UNDP<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">UNFPA<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">UNICEF<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">WHO<\/jats:styled-content>\u2010World Bank Special Programme of Research, Development and Research Training in Human Reproduction (<jats:styled-content style=\"fixed-case\">HRP<\/jats:styled-content>), a co\u2010sponsored programme executed by the World Health Organization (<jats:styled-content style=\"fixed-case\">WHO<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Tweetable abstract<\/jats:title><jats:p>Non\u2010obstetric causes are important contributors to maternal deaths and life\u2010threatening morbidities in Nigerian hospitals.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.15623","type":"journal-article","created":{"date-parts":[[2019,3,21]],"date-time":"2019-03-21T18:05:34Z","timestamp":1553191534000},"page":"41-48","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Non\u2010obstetric causes of severe maternal complications: a secondary analysis of the Nigeria Near\u2010miss and Maternal Death Survey"],"prefix":"10.1111","volume":"126","author":[{"given":"AS","family":"Adeniran","sequence":"first","affiliation":[{"name":"Department of 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