Maternal mortality in Yazd Province, Iran

Abstract

IntroductionFive hundred thousand maternal deaths occur each year worldwide, many of which are in developing countries. The maternal mortality rate is a measure that demonstrates the degree of adequacy of prenatal care and of economic and social conditions. The aim of this study was to determine the frequency and causes of pregnancy-related mortality rates in Yazd Province.MethodsThis cross-sectional study examined the maternal deaths related to pregnancy that were recorded in Yazd Province, Iran, from 2002 to 2011. All maternal deaths that occurred during pregnancy, during delivery, and 42 days after birth were analyzed in this study. The data were collected through a questionnaire, and both direct and indirect causes of maternal deaths were determined.ResultsForty pregnancy-related deaths occurred in this period, and the maternal mortality rate was 20.8 deaths per 100,000 live births. The mean age of death in the mothers in this study was 29.17. Fifty-five percent of women of the women who died delivered their babies by cesarean section, and only 20% of them delivered their babies vaginally. Bleeding was the most common cause of maternal mortality (30%), and it was associated directly with maternal mortality. Furthermore 20% of the mothers died due to heart disease and cardiac complications, which were associated indirectly with maternal mortality.ConclusionCesarean section and its complications were the main cause of death in many cases. Thus, providing a strategic plan to reduce the use of this procedure, educate mothers, and ensure adequate access to pre-maternal care and to care during pregnancy are the most important measures that can be taken to decrease the maternal mortality rate.

Determinants and causes of maternal mortality in Iran based on ICD-MM: a systematic review

“…English N = 896Iran2009–2012XS (descriptive)Descriptive: Mean age 30, Type of delivery (ND 26%, CS 44%, others 30%), Time of death (during pregnancy/childbirth 26%, postpartum 74%), Education (illiterate 18%, primary 72%, university 10%, no response 6%), Place of birth (hospital 67%, home 3%, on the way 2%, no response 28%), Economic status (high 1%, middle 3%, poor 90%, unknown 5%), Occupation (unemployed 91%, employee 9%)Most frequent cause: Hemorrhage (24.2%)17Kamiabi et al 2015 [38]. Farsi N = 1805Iran2007–2012Ecological study (multivariate)RegressionDescriptive: Type of delivery (ND 29%, CS 61%), Education (illiterate 24%, literate 76%), Place of birth (health facility 93%, & home and way 7.2%), Birth attendant (skilled and trained 94%, traditional 6%), Prenatal care (yes 94%, No 6.3%), Completed prenatal care (Yes 66%, No 34%)Determinants: Associated [Completed prenatal care, Type of delivery, Education, Birth place, Birth attendant, Prenatal care, Improved water source], NOT associated [Male literacy, Use of improved sanitation, Attendance of girls in secondary schools]19Karimi-Zarchi et al 2015 [39]. English N = 40Yazd province2002–2011XS (descriptive)Descriptive: Mean age 29, Mean gravidity 2.6, Type of delivery (ND 20%, CS 55% & others 25%), Education (under diploma 40% & diploma or higher 60%), Place of death (hospital 92.5% & home 7.5%), Birth attendant (General practitioner 82.5%, trained midwife 12.5% & Local Midwife/Untrained Midwife 5%), Prenatal care (yes 77.5%, & No 22.5%)Most frequent cause: Hemorrhage (30%)15Tirkesh et al 2015 [40].…”

Maternal mortality due to cardiac disease in low‐ and middle‐income countries

“…Forty‐seven maternal mortality reports were included, reporting on a total of 38,486 maternal deaths in LMIC [13‐19,22‐61]. Study selection is summarised in Figure 1.…”

“…The included reports used different methods to establish the cause of maternal deaths. In six reports, information regarding the cause of death was only based on maternal death notification forms, filled in at facility level (Table 2) [25,28,30,39,48,50]. The report from Botswana in 2015 was a national statistics mortality report.…”

Prevalence and Determinants of Maternal Mortality in Southeastern Iran (2013 - 2017): A Retrospective Cross-sectional Study

“…In the present study, the most common causes of maternal death were bleeding, followed by heart problems, respiratory problems, eclampsia and preeclampsia, and infections. In some studies, bleeding was the leading cause of maternal death (19)(20)(21)(22). Heart diseases, whether caused by the aggravation of heart problems during pregnancy, emboli, myocardial infarction, or the use of MgSO 4 causing cardiac arrest, were also the second most common…”