Maternal Mortality Ratio and Causes of Death in IRI Between 2009 and 2012
Abstract
Objective: The Maternal Mortality Ratio is an important health indicator. We presented the distribution and causes of maternal mortality in Islamic Republic of Iran.
Materials and methods: After provision of an electronic Registry system for date entry, a descriptive-retrospective data collection had been performed for all maternal Deaths in March 2009- March 2012. All maternal deaths and their demographic characteristic were identified by using medical registries, death certificates, and relevant codes according to International Classification of Diseases (ICD-9) during pregnancy, labor, and 42 days after parturition.
Results: During 3 years, there were 5094317 deliveries and 941 maternal deaths (MMR of 18.5 per 1000000 live births). We had access to pertained data of 896 cases (95.2%) for review in our study. Of 896 reported deaths, 549 were classified as direct, 302 as indirect and 45 as unknown. Hemorrhage was the most common cause of maternal mortality, followed by Preeclampsia, Eclampsia and sepsis. Among all indirect causes, cardio -vascular diseases were responsible for 10% of maternal deaths, followed by thromboembolism, HTN and renal diseases.
Conclusion: Although maternal mortality ratio in IRI could be comparable with the developed countries but its pattern is following developing countries and with this study we had provided reliable data for other prospective studies.
Moazzeni MS. Maternal mortality in the Islamic Republic of Iran: on track and in transition. Matern Child Health J 2013;17:577-80.
WHO, UNICEF, UNFPA, The World Bank, and the
United Nations Population Division. Trends in Maternal Mortality: 1990 to 2015. Geneva, World Health Organization, Maternal mortality ratio (modeled estimate, per 100,000 live births), 2015.
World Health Organization, UNICEF, UNFPA, The World Bank. Trends in maternal mortality: 1990 to 2008. Estimates developed by WHO, UNICEF, UNFPA and The World Bank 2010;1-55. www.who.int/reproductivehealth
Kassebaum NJ, Bertozzi-Villa A, Coggeshall MS, Shackelford KA, Steiner C, Heuton KR, et al. Global, regional, and national levels and causes of maternal mortality during 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet 2014;384:980-1004.
Hogan MC, Foreman KJ, Naghavi M, Ahn SY, Wang M, Makela SM, et al. Maternal mortality for 181 countries, 1980–2008: a systematic analysis of progress towards Millennium Development Goal 5.Lancet 2010; 375:1609-23.
Ezegwui H, Onoh R, Ikeako L, Onyebuchi A, Umeora O, Ezeonu P, et al. Investigating Maternal Mortality in a Public Teaching Hospital, Abakaliki, Ebonyi State, Nigeria. Ann Med Health Sci Res 2013;3:75-80.
Karolinski A, Mazzoni A, Belizán JM, Althabe F, Bergel E, Buekens P. Lost opportunities for effective management of obstetric conditions to reduce maternalmortality and severe maternal morbidity in Argentina and Uruguay. Int J Gynaecol Obstet 2010;110:175-80.
Khumanthem PD, Chanam MS, Samjetshabam RD. Maternal mortality and its causes in a tertiary center. J Obstet Gynaecol India 2012; 62:168-71.
Guerrier G, Oluyide B, Keramarou M, Grais R. High maternal and neonatal mortality rates in northern Nigeria: an 8-month observational study. Int J Womens Health 2013; 5:495-9.
Brown G1, Allen L, Torkelson A. Direct patient interventions that can reduce maternal mortality in developing countries: A Systematic Review.Fam Med 2013;45:550-7.
Ronsmans C, Graham WJ; Lancet Maternal Survival Series steering group. Maternal mortality: who, when, where, and why. Lancet 2006;368:1189-200.
Kassebaum NJ, Bertozzi-Villa A, Coggeshall MS, Shackelford KA, Steiner C, Heuton KR, et al. Global, regional, and national levels and causes of maternal mortality during 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet 2014;384:980-1004.
World Health Organization, UNICEF, UNFPA and The World Bank. Trends in maternal mortality: 1990 to 2010. WHO, UNICEF, UNFPA and The World Bank estimates.2012;1-70.
Karimzadeh MA, Taheripanah R, Babazadeh P. Maternal mortality rate and their ethiology in yazd province comparison with other cities of Iran. International Journal of Gynecology and Obstetrics 2000; 70: 34.
Eftekhar-Vaghefi R, Foroodnia S, Nakhaee N. Gaining insight into theprevention of maternal death using narrative analysis: an experience from kerman,iran. Int J Health Policy Manag 2013; 1:255-9.
Andersen BR, Westergaard HB, Bødker B, Weber T, Møller M, Sørensen JL. Maternal mortality in Denmark, 1985-1994.Eur J Obstet Gynecol Reprod Biol 2009; 142:124-8.
ObiechinaNj, Okolie V, Okechukwu Z, Oguejiofor C, Udegbunam O, NwajiakuL,et al. Maternal mortality at NnamdiAzikiwe University TeachingHospital, Southeast Nigeria: a 10-year review (2003-2012). Int J Womens Health2013; 5:431-6.
Montgomery AL, Ram U, Kumar R, Jha P; Million Death Study Collaborators.Maternal mortality in India: causes and healthcare service use based on anationally representative survey. PLoS One 2014;9:e83331.
Nour NM. An introduction to maternal mortality. Rev Obstet Gynecol 2008;1:77–81. 20.
Prata N, Sreenivas A, Vahidnia F, Potts M. Saving maternal lives inresource-poor settings: facing reality. Health Policy 2009;89:131-48.
Thonneau PF, Matsudai T, Alihonou E, De Souza J, Faye O, Moreau JC, et al. Distribution of causes of maternal mortality duringdelivery and post-partum: results of an African multicentre hospital-based study. Eur J Obstet Gynecol Reprod Biol 2004;114:150-4.
Campbell OM, Graham WJ; Lancet Maternal Survival Series steering group.Strategies for reducing maternal mortality: getting on with what works. Lancet.2006; 368:1284-99.
Al Serouri AW, Al Rabee A, BinAfif M, Al Rukeimi A. Reducing maternalmortality in Yemen: challenges and lessons learned from baseline assessment. IntJ Gynaecol Obstet. 2009; 105:86-91.
Khan KS, Wojdyla D, Say L, Gülmezoglu AM, Van Look PF. WHO analysis of causes of maternal death: a systematic review. Lancet 2006; 367:1066-74.
Zanette E, Parpinelli M, Surita FG, Costa ML, Haddad M, Sousa MH, et al. Maternal near miss and death among women with severe hypertensive disorders: a Brazilian multicenter surveillance study. Reprod Health 2014; 11:4.
Sharma BR, Gupta N. Forensic considerations of pregnancy-related maternal deaths: An overview. J Forensic and Leg Med 2009; 16: 233–8.
Safari-Faramani R,Haghdoost A, Nakhaei N, Foroudnia Sh, Mahmoodabadi Z, Safizadeh M. First birth cesarean proportion: A missed indicator in controlling policies. Med J Islam Repub Iran 2016; 30: 394.
Hall MH, Bewley S. Maternal mortality and mode of delivery. Lancet 1999; 354: 776.
Vadnais M, Sachs B. Maternal Mortality with Cesarean Delivery: A Literature Review. Semin Perinatol 2006. 30:242-6.
Lumbiganon P, Laopaiboon M, Gülmezoglu AM, Souza JP, Taneepanichskul S, Ruyan P, et al. Method of delivery and pregnancy outcomes in Asia: the WHO global survey on maternal and perinatal health 2007–08. Lancet 2010; 375: 490–9.
Torkzahrani S. Commentary: childbirth education in iran. J Perinat Educ 2008 Summer;17:51-4.
Clark SL, Belfort MA, Dildy GA, Herbst MA, Meyers JA, Hankins GD. Maternal death in the 21st century: causes, prevention, and relationship to cesarean delivery. Am J Obstet Gynecol 2008;199:36.e1-5; discussion 91-2. e7-11.
Main EK, McCain CL, Morton CH, Holtby S, Lawton ES. Pregnancy-related mortality in California: causes, characteristics, and improvement opportunities. Obstet Gynecol 2015;125:938-47.
Sajedinejad S, Majdzadeh R, Vedadhir A, Tabatabaei MG, Mohammad K. Maternalmortality: a cross-sectional study in global health. Global Health 2015; 11:4.
Files | ||
Issue | Vol 10, No 3 (September 2016) | |
Section | Original Articles | |
Keywords | ||
Maternal Mortality Epidemiology Etiology Hospitals Iran |
Rights and permissions | |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |