Maternal deaths before and during COVID-19 pandemic: Causes and avoidable factors in a tertiary hospital in South Africa, 2018‒2022.
<h4>Aim</h4>To determine the institutional maternal mortality ratio (iMMR) and avoidable factors (AVFs) before and during the COVID-19 pandemic in a tertiary hospital in South Africa.<h4>Methods</h4>This was a retrospective cross-sectional study. We reviewed medical records t...
Saved in:
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2025-01-01
|
| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0326424 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849424091789918208 |
|---|---|
| author | Ongombe Lunda Lawrence Chauke Ghada Daef Gbenga Olorunfemi Nnabuike Chibuoke Ngene |
| author_facet | Ongombe Lunda Lawrence Chauke Ghada Daef Gbenga Olorunfemi Nnabuike Chibuoke Ngene |
| author_sort | Ongombe Lunda |
| collection | DOAJ |
| description | <h4>Aim</h4>To determine the institutional maternal mortality ratio (iMMR) and avoidable factors (AVFs) before and during the COVID-19 pandemic in a tertiary hospital in South Africa.<h4>Methods</h4>This was a retrospective cross-sectional study. We reviewed medical records to compare iMMR and associated AVFs two years before (March 2018 - February 2020) and two years during (March 2020 - February 2022) COVID-19 pandemic.<h4>Results</h4>Fifty-eight maternal deaths were recorded but available data was 57 (35 before and 22 during COVID-19 pandemic). The highest iMMR per 100,000 live births over a 12-month period was 329.1 before and 201.8 during COVID-19 pandemic. The mean ages were 31.0 ± 6.9 and 31 ± 6.2 years, p = 0.822 before and during COVID-19 pandemic, respectively. During COVID-19 pandemic, 40.9% (9/22) were diagnosed with COVID-19. Before and during the pandemic, 71.4% (25/35) and 68.2% (15/22) p = 1.0 were admitted into an intensive care unit (ICU), respectively, with corresponding 74.3% (26/35) and 50% (11/22), p = 0.026 requiring mechanical ventilation. There was a significant difference in the primary causes of death (p = 0.009) for the two periods, with preeclampsia with severe features (22.9%, 8/35) being the leading cause before COVID-19 pandemic compared to COVID-19 (31.8%, 7/22) during the pandemic. AVFs related to healthcare professionals were the most common occurring in 22/35 and 12/22 of the deceased before and during COVID-19 pandemic, respectively. Before COVID-19 pandemic, the most frequent patient-, healthcare professional-, and administrative-related AVFs were failure to book for antenatal care, administration of wrong treatment, and lack of ICU/high care bed spaces, respectively. During COVID-19 pandemic, the most common patient-, healthcare professional- and administrative-related AVFs were delay in seeking medical treatment, lack of critical care skills, and unavailability of ICU/high-care bed spaces, respectively.<h4>Conclusion</h4>iMMR was lower during than before the COVID-19 pandemic. AVFs related to healthcare professionals were the most common. |
| format | Article |
| id | doaj-art-2eed0c962b73492bbf4e62da7edc0224 |
| institution | Kabale University |
| issn | 1932-6203 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj-art-2eed0c962b73492bbf4e62da7edc02242025-08-20T03:30:20ZengPublic Library of Science (PLoS)PLoS ONE1932-62032025-01-01206e032642410.1371/journal.pone.0326424Maternal deaths before and during COVID-19 pandemic: Causes and avoidable factors in a tertiary hospital in South Africa, 2018‒2022.Ongombe LundaLawrence ChaukeGhada DaefGbenga OlorunfemiNnabuike Chibuoke Ngene<h4>Aim</h4>To determine the institutional maternal mortality ratio (iMMR) and avoidable factors (AVFs) before and during the COVID-19 pandemic in a tertiary hospital in South Africa.<h4>Methods</h4>This was a retrospective cross-sectional study. We reviewed medical records to compare iMMR and associated AVFs two years before (March 2018 - February 2020) and two years during (March 2020 - February 2022) COVID-19 pandemic.<h4>Results</h4>Fifty-eight maternal deaths were recorded but available data was 57 (35 before and 22 during COVID-19 pandemic). The highest iMMR per 100,000 live births over a 12-month period was 329.1 before and 201.8 during COVID-19 pandemic. The mean ages were 31.0 ± 6.9 and 31 ± 6.2 years, p = 0.822 before and during COVID-19 pandemic, respectively. During COVID-19 pandemic, 40.9% (9/22) were diagnosed with COVID-19. Before and during the pandemic, 71.4% (25/35) and 68.2% (15/22) p = 1.0 were admitted into an intensive care unit (ICU), respectively, with corresponding 74.3% (26/35) and 50% (11/22), p = 0.026 requiring mechanical ventilation. There was a significant difference in the primary causes of death (p = 0.009) for the two periods, with preeclampsia with severe features (22.9%, 8/35) being the leading cause before COVID-19 pandemic compared to COVID-19 (31.8%, 7/22) during the pandemic. AVFs related to healthcare professionals were the most common occurring in 22/35 and 12/22 of the deceased before and during COVID-19 pandemic, respectively. Before COVID-19 pandemic, the most frequent patient-, healthcare professional-, and administrative-related AVFs were failure to book for antenatal care, administration of wrong treatment, and lack of ICU/high care bed spaces, respectively. During COVID-19 pandemic, the most common patient-, healthcare professional- and administrative-related AVFs were delay in seeking medical treatment, lack of critical care skills, and unavailability of ICU/high-care bed spaces, respectively.<h4>Conclusion</h4>iMMR was lower during than before the COVID-19 pandemic. AVFs related to healthcare professionals were the most common.https://doi.org/10.1371/journal.pone.0326424 |
| spellingShingle | Ongombe Lunda Lawrence Chauke Ghada Daef Gbenga Olorunfemi Nnabuike Chibuoke Ngene Maternal deaths before and during COVID-19 pandemic: Causes and avoidable factors in a tertiary hospital in South Africa, 2018‒2022. PLoS ONE |
| title | Maternal deaths before and during COVID-19 pandemic: Causes and avoidable factors in a tertiary hospital in South Africa, 2018‒2022. |
| title_full | Maternal deaths before and during COVID-19 pandemic: Causes and avoidable factors in a tertiary hospital in South Africa, 2018‒2022. |
| title_fullStr | Maternal deaths before and during COVID-19 pandemic: Causes and avoidable factors in a tertiary hospital in South Africa, 2018‒2022. |
| title_full_unstemmed | Maternal deaths before and during COVID-19 pandemic: Causes and avoidable factors in a tertiary hospital in South Africa, 2018‒2022. |
| title_short | Maternal deaths before and during COVID-19 pandemic: Causes and avoidable factors in a tertiary hospital in South Africa, 2018‒2022. |
| title_sort | maternal deaths before and during covid 19 pandemic causes and avoidable factors in a tertiary hospital in south africa 2018 2022 |
| url | https://doi.org/10.1371/journal.pone.0326424 |
| work_keys_str_mv | AT ongombelunda maternaldeathsbeforeandduringcovid19pandemiccausesandavoidablefactorsinatertiaryhospitalinsouthafrica20182022 AT lawrencechauke maternaldeathsbeforeandduringcovid19pandemiccausesandavoidablefactorsinatertiaryhospitalinsouthafrica20182022 AT ghadadaef maternaldeathsbeforeandduringcovid19pandemiccausesandavoidablefactorsinatertiaryhospitalinsouthafrica20182022 AT gbengaolorunfemi maternaldeathsbeforeandduringcovid19pandemiccausesandavoidablefactorsinatertiaryhospitalinsouthafrica20182022 AT nnabuikechibuokengene maternaldeathsbeforeandduringcovid19pandemiccausesandavoidablefactorsinatertiaryhospitalinsouthafrica20182022 |