PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “MATERNAL MORTALITY”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 163 records · Page 9Linked to original sources
PubMed1999

Nationwide maternal mortality in Surinam.

OBJECTIVE: To assess the magnitude, causes and associated factors of maternal mortality in Surinam. METHODS: Nationwide confidential enquiry. Maternal deaths were identified using various methods and sources for the period 1991-1993. All cases were examined by a maternal mortality expert committee for substandard care analysis. RESULTS: The national maternal mortality ratio was 226 per 100,000 live births, which is six times higher than the official maternal mortality ratio of 38 for the preceding three year period. The main causes of death were haemorrhage (30%) and pre-eclampsia (20%). In 95% of analysed cases, substandard care factors which had contributed to the deaths were present at one or more levels of maternity care. CONCLUSIONS: Maternal mortality was found to be several times higher than had been officially reported for Surinam during the previous three decades. Improvement of maternity care services in Surinam is needed, and has to be addressed at all levels, from the community, health centre and hospital to the highest level of organisation.

Adolescent↗
PubMed1997

High maternal mortality levels and additional risk from poor accessibility in two districts of northern province, Zambia.

BACKGROUND: Maternal mortality ratios in Kasama and Kaputa Districts, two remote rural areas of Northern Province, Zambia, were suspected to be very high. In order to evaluate the impact of a referral system baseline maternal mortality levels and additional maternal mortality risk arising from poor accessibility were estimated. METHODS: The sisterhood method was applied to a random population sample of 3123 respondents in Kasama District and to 2953 in Kaputa District during May and June 1995. For Kasama also hospital-based maternal mortality was calculated from record analysis from 1 January 1991 up to 31 December 1995. Population attributable risk and population etiological fraction were calculated for Kasama District. RESULTS: Maternal mortality ratio for Kasama District was 764 per 100,000 live births and 1549 for Kaputa District. Kasama hospital-based maternal mortality was 543 per 100,000 live births. In Kasama District population attributable risk of maternal mortality from poor accessibility was 220 maternal deaths per 100,000 live births, and the population etiological fraction was 29%. In Kaputa District population attributable risk was 1006 maternal deaths per 100,000 live births, and the population etiological fraction was 65%. CONCLUSIONS: This study suggests that solving the accessibility problem would decrease the mortality burden from maternal causes with at least 29% in Kasama District and 65% in Kaputa District.

Developing Countries↗
PubMed2005

Factors contributing to maternal mortality in north-central Nigeria: a seventeen-year review.

Maternal mortality ratio in Nigeria is one of the highest in the world. This paper reports a facility based study in north-central Nigeria to determine the magnitude, trends, causes and characteristics of maternal deaths before and after the launch of the Safe Motherhood Initiative in Nigeria, with a view to suggesting strategic interventions to reduce these deaths. The records of all deliveries and case files of all women who died during pregnancy and childbirth between January 1, 1985 and December 31, 2001, in the maternity unit of Jos University Teaching Hospital, Jos, Nigeria, were reviewed. Data collected were analysed for socio-biological variables including age, booking status, educational level, parity, ethnic group, marital status, mode of delivery, duration of hospital stay before death occurred, cause (s) of maternal deaths. There were 38,768 deliveries and 267 maternal deaths during the period under review, giving a maternal mortality ratio (MMR) of 740/ 100,000 total deliveries. The trend fluctuated between 450 in 1990 and 1,010/100.000 deliveries in 1994. The mean age of maternal death was 26.4 (SD 8.1) years. The greatest risk of MMR was among young teenagers (> 15 years) and older women (< 40 years). Parity-specific maternal mortality ratio was highest in the grand multiparous women. Unbooked as well as illiterate women were associated with very high maternal mortality ratio. The Hausa - Fulani ethnic group contributed the largest number (44%) by tribe to maternal mortality in our study. The major direct causes of deaths were haemorrhage (34.6%), sepsis (28.3%), eclampsia (23.6%) and unsafe abortion (9.6%). The most common indirect causes of death were hepatitis (18.6%), anaesthetic death (14.6%), anaemia in pregnancy (14.6%), meningitis (12.0%), HIV/AIDS (10.6%) and acute renal failure (8.0%). Seventy-nine percent of the maternal deaths occurred within 24 hours of admission. Most of the deaths were preventable. A regional-specific programme should be planned to reduce the deplorably high maternal mortality in north-central Nigeria.

Adolescent↗
PubMed1985

Maternal health services and maternal mortality in Papua New Guinea.

Surveys of maternal mortality rates in rural areas of Papua New Guinea over the past thirty years report 2-18 deaths per 1000 live births. The national maternal mortality register commenced in 1970 and reports rates of 2-7/1000 deaths for urban areas and 7-20/1000 deaths for rural areas. However, less than a quarter of maternal deaths are believed to be reported to the register: most of the unreported deaths are unsupervised confinements. Nevertheless obstetrical causes now account for 20% of total admissions to hospital and health centres in Papua New Guinea, and are the commonest causes of admission. The great majority of obstetrical admissions come from urban and periurban areas. Most rural women continue to confine at home where only a small fraction of maternal deaths are reported. It is as yet unclear whether modern health services have made any impact on rural maternal mortality rates. A plea is made for more complete reporting of maternal deaths to the national register of both supervised and unsupervised confinements.

Female↗
PubMed2004

Maternal mortality--a ten-year study.

Maternal deaths in Kasturba Hospital, during the 10-year period from January 1989 to December 1998 were studied. A total of 419 deaths were recorded among 1,12,133 deliveries, with an average maternal mortality rate of 360. The year wise maternal mortality rate showed an almost consistent decline from 468 to 190 over the decade. Almost all the deaths (95%) occurred among unbooked gravidas. Indirect causes claimed 62.5% lives while 33.8% were due to direct obstetric causes and 15 (3.6%) deaths were due to coincidental causes. Severe anaemia was the largest killer, causing 31% of total deaths. Majority (65.6%) of deaths occurred in the postnatal period. Most of the deaths could have been prevented by better community participation, antenatal care, iron-folate prophylaxis and timely medical care.

Adult↗
PubMed2001

Maternal mortality at the end of a decade: signs of progress?

Maternal mortality is an important measure of women's health and indicative of the performance of health care systems. Several international conferences, most recently the Millennium Summit in 2000, have included the goal of reducing maternal mortality. However, monitoring progress towards the goal has proved to be problematic because maternal mortality is difficult to measure, especially in developing countries with weak health information and vital registration systems. This has led to interest in using alternative indicators for monitoring progress. This article examines recent trends in two indicators associated with maternal mortality: the percentage of births assisted by a skilled health care worker and rates of caesarean delivery. Globally, modest improvements in coverage of skilled care at delivery have occurred, with an average annual increase of 1.7% over the period 1989-99. Progress has been greatest in Asia, the Middle East and North Africa, with annual increases of over 2%. In sub-Saharan Africa, on the other hand, coverage has stagnated. In general, caesarean delivery rates were stable over the 1990s. Countries where rates of caesarean deliveries were the lowest--and where the needs were greatest--showed the least change. This analysis leads us to conclude that whereas there may be grounds for optimism regarding trends in maternal mortality in parts of North Africa, Latin America, Asia, and the Middle East, the situation in sub-Saharan Africa remains disquieting.

Cesarean Section↗
PubMed1994

Assessment of maternal mortality in Tanzania.

OBJECTIVE: To assess maternal mortality. DESIGN: Prospective community-based survey, a sisterhood method survey and hospital data. SETTING: The study was performed in communities in a rural area in Northwestern Tanzania and the local district hospital. RESULTS: Four hundred and forty-seven pregnant women in the community survey were followed up as far as six weeks after delivery; there were 2865 respondents in the sisterhood survey; the hospital study involved 7526 deliveries. Maternal morality ratios derived from the prospective community-based survey, the sisterhood method survey and hospital data analysis were 241, 297, and 845 per 100,000 live births, respectively. CONCLUSIONS: Hospital data tend to overestimate maternal mortality in these communities. The sisterhood method is easier and more convenient than a prospective community-based study.

Adolescent↗
PubMed1983

Maternal mortality in Riyadh, Saudi Arabia.

The maternal mortality in the Maternity and Children Hospital, Riyadh, during the years 1978-1980 was 52 per 100 000 births, when the total births were 55 428. This is higher than the rate reported from the hospitals in developed countries but lower than rates reported by the university hospitals of developing countries such as India, Thailand and Nigeria. Haemorrhage, associated disease, pulmonary embolism and infection, in that order, were the main causes of maternal deaths. The main avoidable factor was failure by the patient to seek the medical care. Much could be done in reducing deaths due to haemorrhage by improving blood transfusion facilities in the peripheral hospitals. Adequate health education, especially of rural women and their midwives, is a crucial factor in improving the maternal death rate for the country as a whole.

Abortion, Spontaneous↗
PubMed2001

Maternal mortality in Greece (1980-1996).

OBJECTIVE: To use data from the National Statistical Service of Greece to examine trends in maternal mortality and risk factors for maternal deaths. STUDY DESIGN: Maternal mortality in Greece has been studied from years 1980 to 1996 in total, by cause of death, by residency (urban/rural) and by maternal age. The maternal mortality ratio (MMR) has been defined as the number of deaths per 100,000 live births. RESULTS: From years 1980 to 1996, there have been 136 maternal deaths (MMR: 7). The number of deaths has significantly decreased during this period and six major causes of death have been identified, resulting in 80% of maternal deaths. A simulation of maternal mortality between urban and rural areas has been achieved during the last decade. Also, maternal mortality rises dramatically with age. CONCLUSIONS: Although overall rates of maternal mortality in Greece have been significantly decreased over the last years, an improved recording of maternal deaths is necessary for identifying preventable factors and developing effective interventions.

Adult↗
PubMed1994

Estimating maternal mortality in rural areas of Mexico: the application of an indirect demographic method.

OBJECTIVE: To measure maternal mortality levels in rural areas of Mexico. METHODS: In a cross-sectional study, a census of 13,378 households was carried out in the municipalities of Yecapixtla and Tlaltizapan, Morelos, Mexico. Information on 10,443 subjects from 12 to 49 years old was included in the analysis. An indirect method of measuring maternal mortality--the sisterhood method--was used to estimate maternal mortality. Information about the number of sisters of the interviewees who died due to maternal causes was collected in the census. With this information, estimates of maternal mortality related to a period of 10-12 years before the application of the census were obtained. An innovation to the original method was the calculation of a confidence interval for the estimated maternal mortality rate (MMR). RESULTS: The MMR in this region was 18.68/10,000 live births (95% CI 15.79-21.58/10,000 live births). The average risk of dying due to maternal causes was 1 in 87 for women between 12 and 49 years of age. CONCLUSIONS: The sisterhood method was effective for estimating maternal mortality in a small region, with no previous information about this indicator. The method proved to be useful for identifying a priority region for the implementation of maternal mortality reduction programs. Furthermore, the method was particularly convenient since it was applied as part of a multipurpose survey.

Adolescent↗
PubMed2003

[Analysis of maternal mortality in China from 1996 to 2000].

OBJECTIVE: To study the trend and characteristics of maternal mortality in China from 1996 to 2000. METHODS: Population-based epidemiological survey in 116 monitoring units in China were used. RESULTS: Maternal mortality in China dropped by 17.1% from 63.9 per 100,000 live births in 1996 to 53.0 in 2000, in rural area dropped by 22.2% from 86.4 per 100,000 live births to 67.2, and in urban area only 1.0% from 29.2 per 100 000 live births to 28.9, the leading causes of maternal mortality in China are hemorrhage, preeolampsia/eclampsia and amniotic fluid embolism the maternal mortality due to hemorrhage in national level and rural level has declined by 33.8%, 34.9% respectively. CONCLUSION: The maternal mortality appears a declined trend on both the national and rural levels in China from 1996 to 2000, the maternal mortality due to hemorrhage dose also, bur the maternal mortality in urban area keeps unstable.

Cause of Death↗
PubMed1985

The decline in maternal mortality in Sweden, 1931-1980.

Maternal mortality in Sweden has declined steeply over the past 50 years. The reasons for this gratifying trend have been analysed. A decreasing incidence of complications during pregnancy and delivery, together with a lower case fatality rate from complications have been found to account for the major part of the reduction in maternal mortality in Sweden. This has been achieved by improvements in obstetrical and antenatal care, by the introduction of antibiotics and blood transfusion, and by a favorable shift to more appropriate ages for reproduction.

Eclampsia↗
PubMed1990

A 10-year review of maternal mortality in a municipal hospital in Rio de Janeiro: a cause for concern.

A 10-year review of maternal mortality was conducted at the Municipal Hospital Miguel Couto in Rio de Janeiro. Thirty-two deaths occurred between January 1978 and December 1987. In the same period there were 18,071 live births, giving an overall maternal mortality ratio of 177 per 100,000 live births. Maternal mortality increased from 128 per 100,000 live births in 1978 to 462 per 100,000 in 1987. Abortion-related deaths accounted for 47% of the total mortality, followed by toxemia (19%) and hemorrhage (13%). The contribution of abortion-related mortality to maternal mortality increased 172% over the 10-year period studied. These results indicate that maternal mortality has been increasing in a population of urban poor and that the leading cause of death is induced abortion. In a setting where access to abortion is highly restricted and desire to regulate fertility is high, death due to illegal abortion is a major contributor to maternal mortality. The rise in abortion-related mortality over the past 10 years is attributed to a lack of family planning services in conjunction with urban socioeconomic conditions conducive to smaller families.

Abortion, Induced↗
PubMed2005

National maternal mortality ratio in Egypt halved between 1992-93 and 2000.

Two surveys of maternal mortality conducted in Egypt, in 1992-93 and in 2000, collected data from a representative sample of health bureaus covering all of Egypt, except for five frontier governorates which were covered only by the later survey, using the vital registration forms. The numbers of maternal deaths were determined and interviews conducted. The medical causes of death and avoidable factors were determined. Results showed that the maternal mortality ratio (MMR) had dropped by 52% within that period (from 174 to 84/100,000 live births). The National Maternal Mortality Survey in 1992-93 (NMMS) revealed that the metropolitan areas and Upper Egypt had a higher MMR than Lower Egypt. In response to these results, the Egyptian Ministry of Health and Population (MOHP) intensified the efforts of its Safe Motherhood programmes in Upper Egypt with the result that the regional situation had reversed in 2000. Consideration of the intermediate and outcome indicators suggests that the greatest effect of maternal health interventions was on the death-related avoidable factors "substandard care by health providers" and "delays in recognizing problems or seeking medical care". The enormous improvements in these areas are certainly due in part to extensive training, revised curricula, the publication of medical protocols and services standards, the upgrading of facilities, and successful community outreach programmes and media campaigns. The impact on the utilization of antenatal care (ANC) has been less successful. Other areas that remain problematic are inadequate supplies of blood, drugs and equipment. Although the number of maternal deaths linked to haemorrhage has been drastically reduced, it remains the primary cause. The drop in maternal mortality in the 1990s in response to Safe Motherhood programmes was impressive and the ability to tailor interventions based on the data from the NMMS of 1992-93 and 2000 was clearly demonstrated. To ensure the continuing availability of information to guide and evaluate programmes for reducing maternal mortality, an Egyptian national maternal mortality surveillance system is being developed.

Adolescent↗
PubMed2002

Maternal mortality in India: an update.

This study presents estimates of maternal mortality for India from two indirect procedures, the sisterhood method and a regression method involving sex differentials in adult mortality, and compares them with estimates available from other sources. The sisterhood method is applied to the data collected in a human development survey that covered all rural areas of India in 1994, while the latter method is applied to the data on mortality and fertility rates from India's Sample Registration System. The level of maternal mortality for the early 1980s implied by the sisterhood method is found to be about 15 percent lower than the estimate for the same period derived from the method that uses the data on sex differentials in adult mortality. The estimate for the 1990s from the latter method is consistent, however, with the direct estimates available from the National Family Health Survey and the Sample Registration System. The study also discusses the socioeconomic differentials in maternal mortality implied by the sisterhood data, and spatial and temporal variations in maternal mortality derived from the regression method.

Adolescent↗
PubMed1999

Classification differences and maternal mortality: a European study. MOMS Group. MOthers' Mortality and Severe morbidity.

OBJECTIVES: To compare the ways maternal deaths are classified in national statistical offices in Europe and to evaluate the ways classification affects published rates. METHODS: Data on pregnancy-associated deaths were collected in 13 European countries. Cases were classified by a European panel of experts into obstetric or non-obstetric causes. An ICD-9 code (International Classification of Diseases) was attributed to each case. These were compared to the codes given in each country. Correction indices were calculated, giving new estimates of maternal mortality rates. SUBJECTS: There were sufficient data to complete reclassification of 359 or 82% of the 437 cases for which data were collected. RESULTS: Compared with the statistical offices, the European panel attributed more deaths to obstetric causes. The overall number of deaths attributed to obstetric causes increased from 229 to 260. This change was substantial in three countries (P < 0.05) where statistical offices appeared to attribute fewer deaths to obstetric causes. In the other countries, no differences were detected. According to official published data, the aggregated maternal mortality rate for participating countries was 7.7 per 100,000 live births, but it increased to 8.7 after classification by the European panel (P < 0.001). CONCLUSION: The classification of pregnancy-associated deaths differs between European countries. These differences in coding contribute to variations in the reported numbers of maternal deaths and consequently affect maternal mortality rates. Differences in classification of death must be taken into account when comparing maternal mortality rates, as well as differences in obstetric care, underreporting of maternal deaths and other factors such as the age distribution of mothers.

Cause of Death↗
PubMed1996

Determinants of maternal mortality in rural China.

A case-control study of maternal mortality was conducted in selected rural areas of two provinces in China: Henan province, which has a relatively lower socio-economic status and higher maternal mortality rates, and Jiangsu province with higher socio-economic status and lower maternal mortality rates. The major cause of maternal mortality in the two provinces was postpartum hemorrhage and the largest proportion of deaths occurred on the road between the women's home and the health care facility. Results indicate that the expectant mother's socio-economic status, knowledge of maternal care, and the nature and level of maternal care provided all influence rural maternal death rates. However, socio-economic factors were only significant predictors of mortality in the poorer province. Implications for health policy and future research are discussed.

Age Factors↗