Investigation of maternal near-miss cases and associated factors in tertiary health institutions in Eskişehir province: A case-control study

This study aimed to determine the incidence of maternal near-miss (MNM) cases in tertiary healthcare institutions in Eskişehir, examine the associated risk factors, and contribute to improving maternal health services. The study was a retrospective case-control study conducted in tertiary hospitals in Eskişehir, namely Eskisehir Osmangazi University (ESOGÜ) Health, Application, and Research Hospital, and the Ministry of Health Eskisehir City Hospital (EŞH). The medical records of 10,360 women who gave birth in these hospitals between January 1, 2022, and December 31, 2023, were reviewed. A total of 53 cases and 159 controls, selected according to the World Health Organization (WHO) MNM criteria, comprised the study sample. The data were analyzed using the Mann-Whitney U test, chi-square test, Fisher's Exact test, and univariate and multivariate logistic regression analyses. The MNM incidence was calculated as 5.18 per 1,000 live births. Multivariate analysis identified anemia, preterm birth, prior cesarean delivery, short interpregnancy interval (≤2 years), and the presence of chronic disease as independent risk factors for MNM. The most common severe maternal complications in the case group were postpartum hemorrhage, uterine rupture, and preeclampsia. Additionally, 30.2% of the women in the case group were admitted to the intensive care unit, and the most frequent critical intervention was blood product transfusion (73.6%). In conclusion, expanding anemia screening and treatment programs, strengthening antenatal care services, reducing preterm birth risks, and controlling cesarean delivery rates are necessary to reduce maternal morbidity and mortality. As a result of the study, it was concluded that the use of the term "Maternal Ölüme Ramak Kala" (MÖRK) in the Turkish literature and its inclusion among maternal and child health indicators could contribute to the development of maternal health policies. Maternal near miss, maternal health, maternal morbidity, case-control study, Eskişehir