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Table 3 Adverse maternal outcomes among different management groups in WHOGS, WHOMCS and Combined databases

From: Management of pregnancy at and beyond 41 completed weeks of gestation in low-risk women: a secondary analysis of two WHO multi-country surveys on maternal and newborn health

Adverse maternal outcomes WHOGS WHOMCS Combined
n/N (%) Crude ORa (95% CI) AORb (95% CI) n/N (%) Crude ORa (95% CI) AOR* (95% CI) n/N (%) Crude ORa (95% CI) AORb (95% CI)
PPH
 IOL 88/2119 (4.2) 1 1 38/2213 (1.7) 1 1 126/4332 (2.9) 1 1
 ECS 11/691 (1.6) 0.78 (0.39, 1.56) 0.66 (0.30, 1.44) 19 /1260 (1.5) 1.01 (0.54, 1.87) 0.99 (0.50, 1.98) 30 /1951 (1.5) 1.01 (0.66, 1.53) 0.89 (0.56, 1.43)
 EM 542/13338 (4.1) 1.12 (0.84, 1.51) 1.21 (0.86, 1.70) 173/13382 (1.3) 0.88 (0.58, 1.33) 0.91 (0.57, 1.45) 715/26720 (2.7) 1.03 (0.82, 1.29) 1.03 (0.80, 1.33)
Ruptured uterus
 IOL 3/2119 (0.5) 1 1 0/2213 (0.0) 3/4332 (0.1) 1 1
 ECS 2/691 (0.3) 0.65 (0.10, 4.04) 0.40 (0.05, 3.22) 0 /1260 (0.0) 2 /1951 (0.1) 0.74 (0.15, 3.60) 0.48 (0.07, 3.05)
 EM 40/13338 (1.2) 2.70 (0.79, 9.28) 1.52 (0.32, 7.16) 10/13382 (0.1) 50/26720 (0.3) 3.29 (1.16, 9.33) 1.98 (0.51, 7.65)
Admission to ICU
 IOL 24/2119 (1.1) 1 1 0/2213 (0.0) 24/4332 (0.6) 1 1
 ECS 5/691 (0.7) 1.85 (0.58, 5.88) 1.17 (0.35, 4.03) 0 /1260 (0.0) 5 /1951 (0.3) 1.21 (0.49, 2.96) 1.09 (0.36, 3.31)
 EM 258/13338 (1.9) 0.62 (0.37, 1.03) 0.60 (0.34, 1.03) 8/13382 (0.1) 266/26720 (1.0) 0.69 (0.44, 1.07) 0.66 (0.39, 1.13)
Postpartum length of stay >7 days
 IOL 76/2119 (3.6) 1 1 44/2213 (2.0) 1 1 120/4332 (2.8) 1 1
 ECS 21/691 (3.0) 2.18 (1.29, 3.68) 1.22 (0.68, 2.19) 49 /1260 (3.9) 2.33 (1.51, 3.60) 1.54 (0.96, 2.49) 70 /1951 (3.6) 2.16 (1.57, 2.99) 1.33 (0.93, 1.90)
 EM 373/13338 (2.8) 1.08 (0.80, 1.45) 0.98 (0.71, 1.35) 424/13382 (3.2) 0.81 (0.57, 1.15) 0.83 (0.57, 1.21) 797/26720 (3.0) 0.91 (0.73, 1.13) 0.87 (0.69, 1.11)
Severe maternal outcomec
 IOL 52/2119 (2.5) 1 1 4/2213 (0.2) 1 1 56/4332 (1.3) 1 1
 ECS 14/691 (2.0) 1.41 (0.73, 2.70) 1.15 (0.57, 2.34) 3 /1260 (0.2) 1.41 (0.30, 6.63) 0.64 (0.10, 3.97) 17 /1951 (0.9) 1.42 (0.83, 2.46) 1.08 (0.59, 1.96)
 EM 382/13338 (2.9) 0.80 (0.56, 1.14) 0.86 (0.59, 1.27) 18/13382 (0.1) 0.67 (0.21, 2.13) 0.55(0.16, 1.79) 400/26720 (1.5) 0.77 (0.56, 1.04) 0.80 (0.57, 1.13)
CS rate
 IOL 590/2119 (27.8) 1 1 690/2213 (31.2) 1 1 1280/4332 (29.6) 1 1
 EM 3416/13338 (25.6) 0.82 (0.73, 0.92) 0.76 (0.66,0.87) 3463/13382 (25.9) 0.69 (0.61, 0.77) 0.67 (0.59,0.76) 6879/26720 (25.7) 0.74 (0.68, 0.80) 0.70 (0.64,0.77)
  1. (IOL Induction of labour group, ECS Elective Caesarean section group, EM Expectant management group) aCrude ORs were calculated by multilevel logistic regression model after accounted for cluster effect (facility level and country level) bAdjusted – for maternal characteristics (age, marital status, education, parity, previous CS); neonatal characteristics (birth weight); facility capacity index score and cluster effect (health facility level, country level in WHOGS and WHOMCS; one more level (data source – WHOGS & WHOMCS) in combined database cSevere maternal outcome – presence of at least one of maternal death, blood transfusion, hysterectomy, eclampsia and admission to ICU in WHOGS; presence of maternal death or maternal near miss in WHOMCS (Maternal near miss is defined as WHO criteria)Values in bold mean they are statistically significant (p < 0.05)