Oppong, S.A.Bakari, A.Bell, A.J.Bockarie, Y.Adu, J.A.Turpin, C.A.Obed, S.A.Adanu, R.M.K.Moyer, C.A.2019-05-282019-05-282019-05https://doi.org/10.1111/1471-0528.15578http://ugspace.ug.edu.gh/handle/123456789/30359To explore the incidence and factors associated with maternal near‐miss. Cross‐sectional study with an embedded case‐control study. Three tertiary referral hospitals in southern Ghana. All women admitted to study facilities with pregnancy‐related complications or for birth. An adapted version of the WHO Maternal Near Miss Screening Tool was used to identify maternal near‐miss cases. These were compared with unmatched controls (uncomplicated deliveries) in a ratio of 1:2. Incidence of maternal near‐miss, maternal near‐miss‐maternal mortality ratio, and cause of and factors associated with maternal near‐miss. Out of 8,433 live births, 288 maternal near‐miss cases and 62 maternal deaths were identified. 454 healthy controls were recruited for comparison. Maternal near‐miss and maternal death incidence ratios were 34.2 (95% CI:30.2 ‐ 38.1) and 7.4 (95% CI:5.5 ‐ 9.2) per 1000 live births respectively with a maternal near‐miss‐mortality ratio of 4.6:1. Cause of near‐miss was preeclampsia/eclampsia (41.0%), haemorrhage (12.2%), maternal sepsis (11.1%), and ruptured uterus (4.2%). Major factor associated with maternal near‐miss was maternal fever within the seven days before birth (OR:5.95 95%CI:3.754 ‐ 9.424). Spontaneous onset of labor was protective against near miss OR:0.09 95% CI: 0.057 ‐ 0.141) For every maternal death, there were nearly five maternal near‐misses. Women having a fever in the seven days prior to delivery were six times more likely to experience a near‐miss than women not having fever. This article is protected by copyright. All rights reserved.enMaternal mortalityMaternal near-missMaternal near-miss indicatorsArticle