Estimates of maternal mortality worldwide between 1990 and 2005: an assessment of available data

Hill, Kenneth; Thomas, Kevin J. A.; AbouZahr, Carla; Walker, Neff; Say, Lale; Inoue, Mie; Suzuki, Emi

doi:10.1016/s0140-6736(07)61572-4

Cited by 414 publications

(314 citation statements)

References 11 publications

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“…Although some of this increase is artifact because of improved reporting of deaths, other data suggest an increase in maternal mortality ratio over time in sites with high-quality data. [2], [24], [25] and [26] The UN estimates [22] and [27] and other national data such as a census in 2001 24 suggest that the ratio ranges from 230 per 100 000 to 575 per 100 000 (figure 1).…”

Section: Progress Towards Child Survival and Maternal Healthmentioning

confidence: 99%

Every death counts: use of mortality audit data for decision making to save the lives of mothers, babies, and children in South Africa

Bradshaw¹,

Chopra²,

Kerber³

et al. 2008

The Lancet

100

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Section: Progress Towards Child Survival and Maternal Healthmentioning

confidence: 99%

Every death counts: use of mortality audit data for decision making to save the lives of mothers, babies, and children in South Africa

Bradshaw¹,

Chopra²,

Kerber³

et al. 2008

The Lancet

100

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“…32 Hence, the variations found in our study (1.5-fold to 2-fold) are within the variability expected in multicenter studies. [30][31][32][33] Analysis of the TOCOS cohort led to three main results that could be used as a guide for prenatal counseling and for tailoring clinical surveillance in pregnancy ( Figures 3 and 4, Tables 3-5). The first result is confirmatory, on a much larger scale, of previously reported data.…”

Section: Discussionmentioning

confidence: 99%

Risk of Adverse Pregnancy Outcomes in Women with CKD

Piccoli¹,

Cabiddu²,

Attini³

et al. 2015

Journal of the American Society of Nephrology

297

335

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CKD is increasingly prevalent in pregnancy. In the Torino-Cagliari Observational Study (TOCOS), we assessed whether the risk for adverse pregnancy outcomes is associated with CKD by comparing pregnancy outcomes of 504 pregnancies in women with CKD to outcomes of 836 low-risk pregnancies in women without CKD. The presence of hypertension, proteinuria (.1 g/d), systemic disease, and CKD stage (at referral) were assessed at baseline. The following outcomes were studied: cesarean section, preterm delivery, and early preterm delivery; small for gestational age (SGA); need for neonatal intensive care unit (NICU); new onset of hypertension; new onset/doubling of proteinuria; CKD stage shift; "general" combined outcome (preterm delivery, NICU, SGA); and "severe" combined outcome (early preterm delivery, NICU, SGA). The risk for adverse outcomes increased across stages (for stage 1 versus stages 4-5: "general" combined outcome, 34.1% versus 90.0%; "severe" combined outcome, 21.4% versus 80.0%; P,0.001). In women with stage 1 CKD, preterm delivery was associated with baseline hypertension (odds ratio [OR], 3.42; 95% confidence interval [95% CI], 1.87 to 6.21), systemic disease (OR, 3.13; 95% CI, 1.51 to 6.50), and proteinuria (OR, 3.69; 95% CI, 1.63 to 8.36). However, stage 1 CKD remained associated with adverse pregnancy outcomes (general combined outcome) in women without baseline hypertension, proteinuria, or systemic disease (OR, 1.88; 95% CI, 1.27 to 2.79). The risk of intrauterine death did not differ between patients and controls. Findings from this prospective study suggest a "baseline risk" for adverse pregnancy-related outcomes linked to CKD.

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“…3 However, notwithstanding recent evidence, 4 progress has in general been slow. 5 China has the largest population in the world, and maternal deaths in 1990 comprised almost 4% of the world's total. 6 Progress in reducing maternal mortality in China has been impressive; 4,[7][8][9][10] the MMR decreased from 95 deaths per 100 000 livebirths in 1990 to 45 deaths in 2005, 11,12 a remarkable success given the size and diversity of the country.…”

Section: Introductionmentioning

confidence: 99%

Socio‐economic disparities in maternal mortality in China between 1996 and 2006

Feng

Zhu

Zhang

et al. 2010

BJOG

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Objective China's economic reforms have raised concerns over rising inequalities in maternal mortality, but it is not known whether the gap across socio-economic regions has increased over time.Design A population-based, longitudinal, ecological correlation study.Setting China.Sample Records from the National Maternal and Child Mortality Surveillance System between 1996 and 2006.Methods We report levels, causes and timing of maternal deaths, and examine crude and adjusted time trends in the overall and cause-specific maternal mortality ratio in five socio-economic regions (using Poisson regression). We examine whether socioeconomic disparities have widened over time using concentration curves.Main outcome measures All-causes and cause-specific maternal mortality ratios.Results Maternal mortality (MMR) declined by 6% per year (yearly rate ratio, RR, 0.94; 95% CI 0.93-0.96). The decline was most pronounced in the wealthiest rural type-I counties (RR 0.89; 95% CI 0.85-0.93), and in the poorest rural type-IV counties (RR 0.90; 95% CI 0.82-1.00). There were declines in almost all causes of maternal death. Postpartum haemorrhage (PPH) was by far the leading cause of maternal death (32%, 997/3164). The decline in MMR was largely explained by the increased uptake of institutional births. Concentration curves suggest that wealthrelated regional inequalities did not increase over time.Conclusions China's extraordinary economic growth has not adversely affected disparities in MMR across socio-economic regions over time, but poor rural women remain at disproportionate risk. Other emerging economies can learn from China's focus on the supply and quality of maternity services along with more general health systems strengthening.Keywords China, MDG 5, MMR, socio-economic disparities, time trends.Please cite this paper as: Feng X, Zhu J, Zhang L, Song L, Hipgrave D, Guo S, Ronsmans C, Guo Y, Yang Q. Socio-economic disparities in maternal mortality in China between 1996. BJOG 2010117:1527-1536. IntroductionThe Safe Motherhood Conference held in Nairobi 30 years ago put reduction of maternal mortality on the global health agenda. 1,2 Global campaigns focussing on this issue have accelerated, particularly since the fifth Millennium Development Goal (MDG 5) targeted a reduction in the maternal mortality ratio (MMR) by three-quarters between 1990 and 2015. (www.un.org/millenniumgoals/maternal.shtml.) 3 However, notwithstanding recent evidence, 4 progress has in general been slow. 5 China has the largest population in the world, and maternal deaths in 1990 comprised almost 4% of the world's total. 6 Progress in reducing maternal mortality in China has been impressive; 4,7-10 the MMR decreased from 95 deaths per 100 000 livebirths in 1990 to 45 deaths in 2005, 11,12 a remarkable success given the size and diversity of the country. However, economic reforms have raised Epidemiology concerns over rising inequalities, particularly in poorer regions and among rural migrants in urban settings. [13][14][15][16] Government financing as a p...

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Estimates of maternal mortality worldwide between 1990 and 2005: an assessment of available data

Cited by 414 publications

References 11 publications

Every death counts: use of mortality audit data for decision making to save the lives of mothers, babies, and children in South Africa

Every death counts: use of mortality audit data for decision making to save the lives of mothers, babies, and children in South Africa

Risk of Adverse Pregnancy Outcomes in Women with CKD

Socio‐economic disparities in maternal mortality in China between 1996 and 2006

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