Abstract
INTRODUCTION: The issue of severe maternal morbidity continues to pose a significant public health challenge globally and has recently emerged as a complementary metric for evaluating the quality of maternal health care. Despite reductions in the maternal mortality ratio in Tanzania, severe maternal morbidity remains a significant threat to women of reproductive age. The aim of this study was to examine obstetric complications and the socio-demographic characteristics that are associated with severe maternal morbidity among women who utilized maternal health services at the Mbeya Zone Referral Hospital in Tanzania. METHODS: A facility-based unmatched case-control study was conducted on 768 women (256 cases and 512 controls) at the Mbeya Zonal Referral Hospital in Tanzania. All inpatients fulfilling the criteria of severe maternal morbidity and non-severe maternal morbidity during the study period were eligible for this study. For each identified case, two corresponding women were randomly selected as controls. Bivariate logistic regression analyses were conducted to identify variables for inclusion in the multivariable logistic regression model. RESULTS: The hospital-based severe maternal morbidity incidence ratio was 75.4 per 1,000 live births. Hypertensive and haemorrhagic disorders were the most morbid conditions, comprising 139 (54.3%) and 88 (34.4%), respectively. Women aged 35 years or older (AOR = 2.248, 95% CI: 1.446-3.494), living without a partner (AOR = 2.313, 95% CI: 1.355-3.948) and residing in rural areas (AOR = 2.503, 95% CI: 1.783-3.514) were found to significantly increase the risk of severe maternal morbidity. However, younger women (AOR = 0.480, 95% CI: 0.256-0.890) and those with post-secondary education (AOR = 0.497, 95% CI: 0.297-0.833) revealed a protective effect against severe maternal morbidity. CONCLUSION AND RECOMMENDATIONS: Severe maternal morbidity remains a challenging problem in the Southern Highlands of Tanzania. The findings highlight sociodemographic factors, such as age, marital status, education levels, and place of residence, as significant predictors of severe maternal morbidity. Therefore, integrated strategies targeting specific obstetric complications and relevant sociodemographic factors are essential for effective mitigations.