Maternal Mortality in a Tertiary Care Centre in South India- Comparative Analysis Over 10 Years

Abstract

BACKGROUND Maternal mortality is used as a general indicator to gauge the health and even social status of an Indian mother. Reduction of maternal mortality ratio remains a challenge in India. The aim of the study is to compare the maternal mortality ratio in a tertiary care centre over a span of 10 years and to analyse the changes and trends in maternal mortality with reference to the causes of maternal mortality and sociodemographic factors. MATERIALS AND METHODS A retrospective facility based study was done at Government Medical College, Kozhikode. The detail of maternal death was analysed with respect to age, parity, gestational status of pregnancy and cause of death. Data from a period of 2007-2016 was compiled and compared as two five-year interval to enable a comparative analysis. Causes of death were classified according to World Health Organization application of International Classification of Diseases-Maternal Mortality (ICD-MM) classification. The results were compiled and statistical analysis done using Chi-square and unpaired t-test. RESULTS Over the first 5 years of our study, there were 80,217 livebirths and 87 maternal deaths. The next five years showed a similar trend with 77,473 livebirths and 88 maternal deaths. The maternal mortality ratio for 2007-2011 is 109 per 1 lakh livebirths, while maternal mortality ratio is 114 per 1 lakh livebirths in 2012-2016. There is a gross rise in deaths during antepartum period in 2012-16. The most common cause of mortality is still direct causes constituting 79% in 2007-11 and 56% in 2012-16. Indirect causes have risen from 21% to 37% during 2012-16. CONCLUSION Maternal mortality ratios for both 5 year periods during the 10 years study period are comparable. The sociodemographic profile has also remained constant. There is a definite decline in deaths due to haemorrhage while mortality due to other obstetric causes and non-obstetric causes are rising.