Background: Little is known about the health of women who survive
obstetric complications in poor countries. Our aim was to determine how
severe obstetric complications in Burkina Faso affect a range of health,
social, and economic indicators in the first year post partum.
Methods: We did a prospective cohort study of women with severe
obstetric complications recruited in hospitals when their pregnancy
ended with a livebirth (n=199), perinatal death (74), or a lost
pregnancy (64). For every woman with severe obstetric complications, two
unmatched control women with uncomplicated delivery were sampled in the
same hospital (677). All women were followed up for 1 year.
Findings: Women with severe obstetric complications were poorer and less
educated at baseline than were women with uncomplicated delivery. Women
with severe obstetric complications, and their babies, were
significantly more likely to die after discharge: six (2%) of the 337
women with severe obstetric complications died within 1 year, compared
with none of the women with uncomplicated delivery (unadjusted p=0·001);
17 babies of women with severe obstetric complications died within 1
year, compared with 18 of those born by uncomplicated delivery (hazard
ratio for mortality 4·67, 95% CI 1·68-13·04, adjusted for loss to
follow-up and confounders; p=0·003). Women with severe obstetric
complications were significantly more likely to have experienced
depression and anxiety at 3 months (odds ratio 1·82, 95% CI 1·18-2·80),
to have experienced suicidal thoughts within the past year at all time
points (2·27, 1·33-3·89 at 3 months; 2·30, 1·17-4·50 at 6 months; 2·26,
1·30-3·95 at 12 months), and to report the pregnancy having had a
negative effect on their lives at all time points (1·54, 1·04-2·30 at 3
months; 2·30, 1·56-3·39 at 6 months; 2·44, 1·63-3·65 at 12 months) than
were women with uncomplicated delivery.
Interpretation: Women who give birth with severe obstetric complications
are at greater risk of death and mental-health problems than are women
with uncomplicated delivery. Greater resources are needed to ensure that
these women receive adequate care before and after discharge from
The Lancet (2007) 370 (9595) – Special issue ‘Women Deliver’ – pp. 1329-1337 [DOI:10.1016/S0140-6736(07)61574-8].
Health of women after severe obstetric complications in Burkina Faso: a longitudinal study.