Factors associated with extreme maternal morbidity in colombian caribbean hospital (2021-2022)

Abstract

Introduction: Extreme maternal morbidity (EMM) is a critical indicator of maternal health. This study seeks to identify factors associated with EMM in a hospital in the Colombian Caribbean, considering the scarcity of local research. Sociodemographic and clinical variables are analyzed to generate evidence to guide maternal health policies in the region. Objective: To identify factors associated with extreme maternal morbidity in pregnant women treated at a Colombian Caribbean hospital between January 2021 and January 2022. Methodology: Case-control study (1:2) in pregnant women treated between January 2021 and January 2022. 93 EMM cases and 190 controls were included. Sociodemographic and clinical data were collected from medical records. Bivariate analysis (chi-square, OR) and multivariate analysis (logistic regression) were performed to identify factors associated with EMM, with statistical significance p<0,05. Results: The absence of prenatal check-ups (aOR = 7,16, 95%CI: 2,46; 21,19) and the consumption of toxic substances (aOR = 38,45, 95%CI: 6,72-222,00) were the main variables associated with EMM. Rural origin (aOR = 0,07, 95%CI: 0,03-0,20) and maternal weight <70 kg (aOR = 0,22, 95%CI: 0,10-0,52) acted as protective factors. Sepsis was the most frequent cause of EMM (50,53%), followed by preeclampsia (46,24%). Variables such as educational level, marital status, and socioeconomic status lost significance in the multivariate analysis. Conclusions: The findings underscore the importance of improving access to prenatal check-ups and preventing the consumption of toxic substances during pregnancy. Strategies adapted to the local context are required to reduce EMM in the Colombian Caribbean region.