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Constructing maternal morbidity - towards a standard tool to measure and monitor maternal health beyond mortality.

TitleConstructing maternal morbidity - towards a standard tool to measure and monitor maternal health beyond mortality.
Publication TypeJournal Article
Year of Publication2016
AuthorsChou, D, Tunçalp, Ö, Firoz, T, Barreix, M, Filippi, V, von Dadelszen, P, van den Broek, N, J Cecatti, G, Say, L
Corporate AuthorsMaternal Morbidity Working Group
JournalBMC Pregnancy Childbirth
Volume16
Pagination45
Date Published2016 Mar 02
ISSN1471-2393
KeywordsFemale, Humans, Maternal Health, Maternal Morbidity Working Group, Morbidity, Pregnancy, Pregnancy Complications, Terminology as Topic
Abstract

BACKGROUND: Maternal morbidity is a complex entity and its presentation and severity are on a spectrum. This paper describes the conceptualization and development of a definition for maternal morbidity, and the framework for its measurement: the maternal morbidity matrix, which is the foundation for measuring maternal morbidity, thus, the assessment tool.

DISCUSSION: We define maternal morbidity and associated disability as "any health condition attributed to and/or complicating pregnancy and childbirth that has a negative impact on the woman's wellbeing and/or functioning." A matrix of 121 conditions was generated through expert meetings, review of the International Classification of Diseases and related health problems (ICD-10), literature reviews, applying the definition of maternal morbidity and a cut-off of >0.1% prevalence. This matrix has three dimensions: identified morbidity category, reported functioning impact and maternal history. The identification criteria for morbidity include 58 symptoms, 29 signs, 44 investigations and 35 management strategies; these criteria are aimed at recognizing the medical condition, or the functional impact/disability component that will capture the negative impact experienced by the woman. The maternal morbidity matrix is a practical framework for assessing maternal morbidity beyond near-miss. In light of the emerging attention to Universal Health Coverage (UHC) as part of the post-2015 Sustainable Development Goals (SDGs) planning, a definition and standard identification criteria are essential to measuring its extent and impact.

DOI10.1186/s12884-015-0789-4
Alternate JournalBMC Pregnancy Childbirth
Citation Key509
PubMed ID26935070
PubMed Central IDPMC4774187
Grant List001 / / World Health Organization / International