The near miss criteria and their frequency are shown in Table 1.
The use of the WHO maternal near miss criteria was feasible in the Northeast of Brazil and provided useful information.
It may not be possible to use any neonatal near miss criteria for cross-country comparisons, since supplementary management criteria (CPAP, use of surfactant, etc).
The performance of the WHO near miss criteria was confirmed, with a sensitivity and specificity of 100 and 92%, respectively [ 18].
However, despite the advantage of facilitating a common way to report this occurrence, maternal near miss criteria are still not universally accepted at the present time.
They scrutinized the case notes and reported the diagnoses listed by the providers, the presence of specific near miss criteria, and the timing of the occurrence of complications.
It is important to highlight that neonatal near miss criteria are unable to identify the total number of neonatal deaths, using either pragmatic, management or a combination of these criteria at birth.
The World Health Organization (WHO) used organ dysfunction criteria and parameters of extreme severity specific to Obstetrics to define life-threatening conditions associated with pregnancy, standardizing the maternal near miss criteria [ 8].
The absence of previous studies using these new near miss criteria standardized by the WHO [ 10] made it impossible to obtain the respective ICC values for the variables of interest related to outcome.
In the WHOGS database, pragmatic neonatal near miss criteria were developed using three conditions associated with preterm and perinatal conditions: low birthweight (<1750 g), gestational age under 33 weeks at birth and Apgar score <7 at 5 min of life.
The adoption of a two level screening strategy may lead to the development of a consistent severe maternal morbidity surveillance system but further research is needed before worldwide near miss criteria can be assumed.
