The highest maternal mortality rates are in africa, with a lifetime risk of 1 in 16. Such a high incidence of maternal mortality causes huge losses of human life and social welfare. Note pregnancy history any time medical care is received in the year after delivery. In our analysis of joint causes of death, haemorrhage was the leading cause of maternal death in africa and asia 30% of deaths. Heart disease and stroke caused more than 1 in 3 deaths 34%. Furthermore, other leading causes of maternal mortality are hepatitis, anaesthetic death, meningitis, hivaids, sickle cell anaemia, anaemia and acute renal failure, which is often a complication of eclampsia. May 19, 2016 cardiac disease is the most common cause of indirect death. Maternal mortality or pregnancyrelated death is defined as the death of a woman during pregnancy or within one year of the end of pregnancy from a pregnancy complication. Of the direct causes of maternal death, the leading causes were obstetric hemorrhage followed by hypertensive disorders and pregnancy related infections 5. The maternal mortality ratio mmr is defined as the number of maternal deaths during a given time period per 100,000 live births during the same time period. Levels and causes of maternal morbidity and mortality. The indirect maternal mortality rate has not changed significantly since 2003. Read more about the causes of maternal mortality in nigeria. White black number of deaths 0 20 40 60 80 100 34 sids 17 29 accidents 20 86 birth defects 17 maternal pregnancy 16 complication 4 short gestation 71 low birthweight 44.
In botswana the maternal mortality ratio in 2010 was 163 per 100 000 live births. It is noteworthy that hepatitis was the leading indirect cause of maternal deaths. Conversely, diabetes mellitus was the leading cause of death for those aged 65 and older 9,1% and the second leading cause of death for those. Further, for every maternal death, there are 84 women who suffer from a severe complication. Autopsy is an important tool in the investigation of maternal death. Cause of and contributing factors to maternal deaths.
Causes of maternal deaths in northern nigeria research cyber. The abortion category includes induced abortion, miscarriage, and ectopic pregnancy. A who systematic analysis article pdf available in the lancet global health 26. Tb causes a cd4 drop and an increase in viral replication pregnancy does not appear to increase the risk of tb disease in hiv infected or uninfected women but tb and hiv are independent risk factors for maternal death. Maternal mortality and the consequences on infant and child. Maternal mortality is a major public health issue in developing countries due to its shocking magnitude and lower declining pattern. An introduction to maternal mortality pubmed central pmc. The zmpms findings are consistent with regional studies on maternal mortality which rank hemorrhage as the top killer followed by hypertension figure 2.
The consensus among international organizations is that quality care requires services throughout a womans reproductive life. Other leading causes of death included infections and severe bleeding. Maternal mortality causes, risk factors and prevention community medicine 14,181 views maternal mortality is the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of duration and site of pregnancy from any cause related or aggravated by the pregnancy or its management and not due to any accidental or. While a large variety of factors contribute to maternal mortality, there are some factors that are extremely common and contribute to the largest number of maternal deaths, such as the 10 common causes of maternal mortality listed below.
Maternal death or maternal mortality is defined by the world health organization who as the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes. Most causes of maternal deaths could be addressed 12 yazbeck, a. This overview highlights the most prominent drivers of maternal mortality in the united states and then examines several policy responses to the issue. However, between 1990 and 2010, the global maternal mortality ratio i. Evidencebased interventions for reducing maternal mortality strategically target the main causes of death figure 1. Leading causes of death differ throughout pregnancy and after. Pdf on oct 1, 2014, frederikke storm and others published indirect causes of maternal death find, read and cite all the research you need on researchgate. Improve access to and delivery of quality prenatal care, which includes managing chronic conditions and educating about warning signs. Correlates of maternal mortality in developing countries. Previously, the majority of women who died were reported to have experienced type 1 and 2 delays. High hiv prevalence among maternal deaths attributed to tb. The international classification of diseases icd 10 defined maternal death as the death of a. Maternal hemorrhage new york state department of health. Direct causes of maternal morbidity and mortality include hemorrhage, infection, high blood pressure, unsafe abortion, and obstructed labor.
A wellfunctioning civil registration and vital crvs system, with good attribution of cause of death provides accurate data on the level of maternal mortality and the causes of maternal deaths 11. For analysis purposes, we grouped maternal causes of death into seven main categories of direct and indirect causes. Hypertensive disorders represent the highest cause of death in latin america and the caribbean. Achievement of sexual and reproductive health is also a human rights issue. Maternal mortality in the united states, 1935 to 2007. According to the national institute of health nih, eclampsia convulsions in a pregnant woman resulting from high blood pressure which are often followed by a coma, is one of the top three causes of maternal mortality worldwide. Preeclampsia is the number one cause of maternal deaths in latin. In pregnancies with abortive outcomes, ectopic pregnancy is the leading cause of maternal death 3, 4. While maternal mortality from hemorrhage, pregnancyinduced.
Maternal mortality causes, risk factors and prevention. Levels and causes of maternal mortality and morbidity. Say and colleagues1 noted that 275% of all maternal deaths result from these indirect causes, with the highest proportion of such deaths in south. This is in contrast to developed countries, where other direct causes for example, those related to complications of anaesthesia and caesarean. Organization who analysis of the causes of maternal death esti. The risk of maternal mortality is highest for adolescent girls under 15 years old. Although maternal mortality rates have declined greatly in the developed world, pph remains a leading cause of maternal mortality elsewhere. In other regions, including asia and north africa, even greater headway has been made. Globally, an estimated 289,000 women died during pregnancy in 20, a decline of 45% from 1990.
Young adolescents ages 1014 face a higher risk of complications and death as a result of pregnancy than other women. Recent mmms research found staggering disparities in maternal death rates in the state and identified major causes of pregnancyassociated deaths. Standardize patient care, including delivering highrisk women at hospitals with specialized providers and equipment. Safe motherhood introduction in developing countries, complications related to pregnancy and childbirth are a leading cause of death and.
Direct causes, complications that occur directly as a result of pregnancy or delivery, account for 73 percent of maternal deaths worldwide, with postpartum hemorrhage causing approximately onethird of all maternal deaths 1. Maternal health unfpa united nations population fund. For many women, motherhood is a rewarding experience. Safe motherhood introduction in developing countries, complications related to pregnancy and childbirth are a leading cause of death and disability for women aged 1549 1. Rosenfield worked tirelessly to avert maternal deaths and provide care and. Effect of coinfection hiv increases reactivation of tb and tb mortality tb causes a cd4 drop and an increase in viral replication. Application of the tenth revision of the international classification of diseases icd to deaths during pregnancy, childbirth, and the puerperium icd maternal mortality mm divides maternal deaths into direct obstetric deaths ie, deaths resulting from the obstetric complications of pregnancy, interventions, omissions, incorrect treatment, or a chain of events resulting from any of the. Background while the main causes of maternal mortality in low and middle income countries are well understood, less is known about whether patterns for causes of maternal deaths among adolescents. The major causes of maternal mortality are as follows say and others 2014. Maternal mortality to improve maternal health, barriers that limit access to quality maternal health services must be identified and addressed at all levels of the health system. A leading cause of maternal mortality in settings with a high hiv burden eg 25% of maternal deaths in zambia, 1999.
Goal 5a calls for the reduction of maternal mortality by 75 percent between 1990 and 2015. It provides valuable information about pathophysiological changes in various organs which may be important in the delineation of the sequence of events leading to. To research the causes of maternal death, consider researching the causes of these these diseases that may be similar, or associated with maternal death. Causes of maternal mortality include postpartum hemorrhage, eclampsia. Obstetric emergencies, like severe bleeding and amniotic fluid embolism when amniotic fluid enters a mothers bloodstream, cause most deaths at delivery. The who, in collaboration with the united nations childrens fund, the united nations population fund, the world bank group, and the united nations population division, publishes global estimates of maternal mortality, which are excerpted in this chapter. All women who carry a pregnancy beyond 20 weeks gestation are at risk for pph and its sequelae. Sixtysix percent of deaths occurred in botswanas two referral hospitals. As a result, the united states is increasingly one of the most unsafe countries for women giving birth. It depicts the risk of maternal death relative to the number of live births and essentially captures the risk of death in a single pregnancy or a single live birth. Determinantscauses of maternal mortality in nigeria. Maternal mortality, also known as maternal death, continues to be the major cause of death among women of reproductive age in many countries and remains a serious public health issue especially in developing countries who, 2007. Causes of maternal and child deaths world health organization. Background maternal mortality is referred to the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and site of the preg.
A maternal death is a devastating event, with consequences for the family and society. Data for the causes of maternal deaths are needed to inform policies to improve maternal health. Pdf indirect causes of maternal death researchgate. Regional estimates show that haemorrhage and hypertension are.
Indirect causes, which include deaths due to conditions such as malaria, hivaids and cardiac diseases, account for about onefifth of maternal deaths. Know and communicate about symptoms of complications. The most common causes of maternal death are pregnancy induced hypertension pih, embolism, and obstetrical hemorrhage. Obstetrical hemorrhage is known as the most preventable cause of maternal mortality. Women in developing countries have, on average, many more pregnancies than women in developed countries, and their lifetime risk of death due to pregnancy is higher. In practice, the definition adopted by the international federation of obstetricians and gynecologists is now almost universally applied. While motherhood is often a positive and fulfilling, for too many women it is associated with suffering, ill health and death. We developed and analysed global, regional, and subregional estimates of the causes of. Maternal mortality, risk factors, causes, shinyanga, tanzania 1. In september 2000, 189 world leaders signed a declaration on eight millennium development goals mdgs to improve the lives of women, men, and children in their respective countries united nations general assembly 2000. Cases in which death had direct obstetric causes were fewer than cases in which cause of death was indirect. Therefore, reducing mmr faster is a fundamental national and international.
Maternal health infectious diseases overview briefer. All five of the major direct causes of maternal death haemorrhage, sepsis, unsafe abortion, hypertensive disorders and obstructed labour can be treated at a wellstaffed, wellequipped health facility. Heart disease and stroke cause most deaths overall. Assessment of maternal mortality and its associated causes at. Causes of maternal death have been reported in different studies. Maternal mortality and the consequences on infant and. Maternal mortality has been determined unequally at different times and different regions.
Nonadherence to standard classification of causes of maternal deaths limited institutionalization of mdsr at the grass roots level nonharmonization of maternal death data at district and national levels limited integration of the mdsr system with the civil registration and. The primary causes of maternal deaths were obstetric hemorrhage and indirect causes. Indiana residents, 2017 this figure was run on october 24, 2018. Michigan sheds light on causes of maternal death michigans maternal mortality surveillance mmms began in 1950 and continues to work to improve the health of michigan mothers. Late maternal death late maternal is death of a woman from direct or indirect obstetric causes, more than 42 days but less than one year, after termination of pregnancy. Maternal health refers to the health of women during pregnancy, childbirth and the postpartum period. An overview of the causes of maternal death and infectious diseases 2 hivaids for women aged 1544, hivaids is the leading cause of death globally. With increased coverage of healthcare services, we sought to explore the relative contribution of each type of delay. In this study, the most common cause of maternal death was hemorrhage and then infection and high blood pressure were identified. For others it is a time of ill health and sometimes even death. The leading causes of maternal deaths in the united states are hemorrhage, pregnancyinduced hypertension, embolism, infection, and other chronic medical conditions 3, 4. Autopsy study of maternal deaths by kavatkar an, sahasrabudhe ns.
Global distribution of maternal causes of death a maternal death is defined as the death of a woman while pregnant or within 42 days of termination of pregnancy, regardless of the site or duration of pregnancy, from any cause related to or aggravated by the pregnancy or its management. Emergency obstetric care is critical to reducing maternal mortality. This information is important in refining targeting and ensures efficient 3 ibid 4 unicef. The major causes of maternal morbidity and mortality include haemorrhage, infection, high blood pressure, unsafe abortion, and obstructed labour. Direct causes as the most important factor and of which haemorrhage was the leading cause, pregnancy induced hypertension uterine rupture 3. Hospital respondents used a variety of sources for identifying maternal and perinatal deaths, primarily labour and delivery registers, postnatal registers, and neonatal registers. The main direct causes were haemorrhage 39%, hypertension 22%, and pregnancyrelated sepsis %. The state of the worlds children 2009is dedicated to allan rosenfield, md, dean emeritus, mailman school of public health, columbia university, who passed away on 12 october 2008.
If a woman passes away from an accident or a health issue that doesnt have anything to do with the pregnancy, then it is not considered a pregnancyrelated death. The three delays model proposes that maternal mortality is associated with delays in. Background data for the causes of maternal deaths are needed to inform policies to improve maternal health. Sep 19, 2019 between 2000 and 2017, the maternal mortality ratio mmr, number of maternal deaths per 100,000 live births dropped by about 38% worldwide. While the main causes of maternal death for women of all ages were similar across all regions, the study found significant regional variation for the proportion each cause contributes to total. Maternal health is the health of women during pregnancy, childbirth, and the postpartum period. In 2010, 19 per cent of the 287,000 maternal deaths estimated worldwide took place in india who 2012. Jul 01, 2015 maternal mortality is defined by the world health organization as the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes. It is a priority to reduce this ratio to meet millennium development goal 5 target of 21 per 100 000 live births.
With appropriate strategy and intensive implementation programs, some countries have made remarkable progress, however in developing countries where 99% of maternal death is occurring. Factors associated with maternal mortality in malawi. Mortality and causes of death in south africa, 2015. New estimates show that the leading causes of maternal. Any death occurring among these is not likely to recorded. Immediate, contributing, and underlying causes of death are evaluated and summary of recommendations are drafted for dissemination to professional groups and health systems involved in the care of pregnant and postpartum women to heighten their awareness of the causes of maternal mortality and ways they might be prevented. Maternal death can happen while a woman is pregnant, during labor and delivery, or in the 42 days after childbirth or the termination of pregnancy.
This is in contrast to developed countries, where other direct causesfor example, those related to complications of anaesthesia. The who in year 2008 reported that worldwide, about 80 percent of maternal deaths are due to four major causes severe bleeding, infections, hypertensive disorders in pregnancy eclampsia and obstructed labour. Assessment of maternal and perinatal death surveillance and. Maternal death is caused by hemorrhage, blood clot, infection, unsafe abortion, high blood pressure and obstructed labor. Mortality and causes of death in south africa, 2016.
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