Epidemiology and Predictors of Maternal Near-Miss at Aminu Kano Teaching Hospital: A Prospective Study

Maternal near-miss analysis is a validated quality improvement tool that provides more statistical power than maternal death reviews alone, enabling the identification of avoidable systemic and clinical factors in obstetric emergency care. This study examines the epidemiology and predictors of maternal near-miss events at Aminu Kano Teaching Hospital, Kano State, over a 12-month prospective study period. The WHO near-miss assessment tool is applied to identify all women experiencing severe maternal outcomes based on organ dysfunction criteria during the study period. Prospectively collected data include admission diagnosis, organ dysfunction category, delay type using the Three Delays Model, near-miss ratio, mortality index, and odds of dying. Binary logistic regression identifies predictors of death versus survival among severe maternal outcome cases. SPSS is used for analysis. Available maternal near-miss literature from North West Nigeria identifies obstetric haemorrhage and hypertensive disorders as the two most frequent proximate causes of severe maternal outcome, with first-delay at community level as the most common contributing delay type. The WHO Maternal Near-Miss Indicators and the FIGO definitions of severe maternal morbidity provide the case identification and analytical framework. Findings will support Aminu Kano Teaching Hospital's obstetric quality improvement committee in targeting intervention resources. Keywords: maternal near-miss, severe maternal outcome, predictors, Kano State, North West Nigeria.