{
  "abstract": "ObjectivesTo evaluate the impact of Score MAMA, Ecuadors national obstetric early-warning system, on rates of severe obstetric complications (hypertensive, hemorrhagic, septic), comparing the 2015 pilot phase (Zones 4/9) with the 2016 national rollout.\n\nMethodsQuasi-experimental ecological interrupted time series study using national administrative data from Ecuador (2012-2024). The denominator came from the live-birth registry (ENV-INEC; n = 3 581 602); the numerator came from hospital discharge records (EDG-INEC), classified by ICD-10 code as Blue Code (O14-O15), Red Code (O44-O46/O67/O72), or Yellow Code (O85-O86/O41.1), aggregated monthly across Ecuadors 9 SENPLADES zones. Negative binomial models with a live-birth offset and zone-nested first-order autoregressive (AR1) correlation estimated incidence rate ratios (IRR). A secondary national-annual analysis modeled maternal mortality by code.\n\nResultsWe identified 200 075 discharges for an obstetric complication (Blue = 125 848; Red = 55 049; Yellow = 19 178). Blue Code increased in the pilot phase (IRR 1.27; 95% CI 1.03-1.57) and nationally (IRR 1.20; 95% CI 1.09-1.33); Red and Yellow Code showed no change. A national mortality analysis (817 deaths) found no significant change for any code (IRR 0.76-1.62; CI spanned 1).\n\nConclusionsScore MAMA was associated with a selective increase in recorded hypertensive complications, with no change in hemorrhage, sepsis, or maternal mortality -- a pattern more consistent with improved detection of preeclampsia-eclampsia than a true change in complication incidence.",
  "abstract_shown": true,
  "affiliations": [
    "UNIVERSIDAD INTERNACIONAL DEL ECUADOR"
  ],
  "article_type": "PUBLISHAHEADOFPRINT",
  "arxiv": null,
  "author_total": 6,
  "authors": [
    {
      "name": "A. S. HERDOIZA ALMEIDA"
    },
    {
      "name": "L. G. Paredes"
    },
    {
      "name": "M. A. Guerrero Salinas"
    },
    {
      "name": "A. W. Guayta Valladares"
    },
    {
      "name": "A. A. T. Solorzano"
    },
    {
      "affs": [
        0
      ],
      "name": "E. S. LANAS MENDOZA"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/7q3fawf30vph2.bib",
  "cited_by": 0,
  "doi": "10.64898/2026.10.20.26366065",
  "fulltext_url": "https://www.medrxiv.org/content/10.64898/2026.10.20.26366065v1.full",
  "id": "7q3fawf30vph2",
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  "landing_url": "https://www.medrxiv.org/content/10.64898/2026.10.20.26366065v1",
  "language": null,
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "medrxiv",
      "epidemiology"
    ],
    [
      "openalex",
      "2735|Global Maternal and Child Health"
    ]
  ],
  "openalex": "W7223289279",
  "pdf_url": "https://www.medrxiv.org/content/10.64898/2026.10.20.26366065v1.full.pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-10-20",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/7q3fawf30vph2.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:21:33Z",
      "native_id": "10.64898/2026.10.20.26366065",
      "source": "medrxiv",
      "url": "https://www.medrxiv.org/content/10.64898/2026.10.20.26366065v1"
    }
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  "subjects": [
    {
      "field": "medicine",
      "origin": "medrxiv:epidemiology",
      "subfield": "epidemiology-public-health"
    }
  ],
  "title": "National impact of Score MAMA on obstetric complications in Ecuador, 2012-2024: interrupted time series analysis",
  "title_text": "National impact of Score MAMA on obstetric complications in Ecuador, 2012-2024: interrupted time series analysis",
  "type": "preprint",
  "updated_at": "2026-10-30T12:21:33Z",
  "url": "https://research.draconitic.com/paper/7q3fawf30vph2",
  "venue": "medRxiv",
  "versions": []
}