To investigate the epidemiological characteristics of maternal near miss, and to explore the influencing factors of admission to ICU.

The clinical data of 136 maternal near miss from January 2016 to December 2019 in the Zhongda Hospital affiliated to Southeast University were retrospectively analyzed. These patients were divided into no-ICU group (60 cases) and ICU group (76 cases). Clinical data including age, education, place of residence, referral, pluriparity, prenatal visit, pre-pregnancy BMI, scarred uterus, mode of delivery, gestational weeks, 24-hour amount of postpartum hemorrhage, primary and major pathogenic factors were collected to perform univariate and multivariate logistic regression analysis.

The top three leading causes were postpartum hemorrhage (39.0%), hypertension (19.1%) and heart disease (8.8%). There was no statistically significant difference between the two groups in age, education, place of residence, pluriparity, prenatal visit, scarred uterus, gestational weeks, and 24-hour amount of postpartum hemorrhage. There were statistically significant differences between the two groups in referral (P=0.028), pre-pregnancy BMI (P＜0.001), delivery method (P＜0.015), and main pathogenic factors (P＜0.001). Logistic regression analysis showed that the pre-pregnancy BMI (≥25 kg/m²) (P=0.036) and the main pathogenic factors (pregnancy comorbidities) (P=0.003) were the influencing factors for the admission of maternal near miss into ICU.

The primary pathogenic factors for maternal near miss are still postpartum hemorrhage, hypertension and heart diseases. BMI≥25 kg/m² before pregnancy and pregnancy complications are the risk factors for maternal near miss to be admitted to ICU.