Adverse obstetric outcomes in two Brazilian maternity hospitals
International Journal of Health Care Quality Assurance
ISSN: 0952-6862
Article publication date: 5 January 2021
Issue publication date: 16 February 2021
Abstract
Purpose
Obstetric adverse outcomes (AOs) are an important topic and the use of composite measures may favor the understanding of their impact on patient safety. The aim of the present study was to estimate AO frequency and obstetric care quality in low and high-risk maternity hospitals.
Design/methodology/approach
A one-year longitudinal follow-up study in two public Brazilian maternity hospitals. The frequency of AOs was measured in 2,880 randomly selected subjects, 1,440 in each institution, consisting of women and their newborn babies. The frequency of 14 AOs was estimated every two weeks for one year, as well as three obstetric care quality indices based on their frequency and severity as follows: the Adverse Outcome Index (AOI), the Weighted Adverse Outcome Score and the Severity Index.
Findings
A significant number of mothers and newborns exhibited AOs. The most prevalent maternal AOs were admission to the ICU and postpartum hysterectomy. Regarding newborns, hospitalization for > seven days and neonatal infection were the most common complications. Adverse outcomes were more frequent at the high-risk maternity, however, they were more severe at the low-risk facility. The AOI was stable at the high-risk center but declined after interventions during the follow-up year.
Originality/value
High AO frequency was identified in both mothers and newborns. The results demonstrate the need for public patient safety policies for low-risk maternity hospitals, where AOs were less frequent but more severe.
Keywords
Acknowledgements
Funding: There was not any type of funding for this article.Competing interests: The authors declare that they have no competing interests.Authors’ contributions: ALA contributed to conception and design, data collection and analysis, drafting and revision of the manuscript and gave final approval of the version to be published. SKM contributed to data collection, drafting and revision of the manuscript and gave final approval of the version to be published. FMR contributed to conception and design, drafting and revision of the manuscript and gave final approval of the version to be published. SEMM and MWR contributed to conception and design, data collection and analysis, drafting and revision of the manuscript and gave final approval of the version to be published. GZAS and RTS contributed to conception and design, data analysis, drafting and revision of the manuscript and gave final approval of the version to be published. All authors read and approved the final manuscript.
Citation
Andrade, A.L., Gama, Z.A.d.S., Freitas, M.R.d., Medeiros, W.R., Sousa, K.d.M., Silva, E.M.M.d. and Rosendo, T.S. (2021), "Adverse obstetric outcomes in two Brazilian maternity hospitals", International Journal of Health Care Quality Assurance, Vol. 34 No. 1, pp. 4-18. https://doi.org/10.1108/IJHCQA-02-2020-0026
Publisher
:Emerald Publishing Limited
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