Prevalence and risk factors for maternal mortality at a tertiary care centre in Eastern Nepal- retrospective cross sectional study

Abstract

Background The maternal mortality ratio is a significant public health indicator that reflects the quality of health care services. The prevalence is still high in developing countries than in the developed countries. This study aimed to determine the MMR and identify the various risk factors and causes of maternal mortality. Methods This is a retrospective study conducted in a tertiary care center in Eastern Nepal from 16th July 2015 to 15th July 2020. The maternal mortality ratio was calculated per 100,000 live-births over five year’s study period. The causes of death, delays of maternal mortality and, different sociodemographic profiles were analyzed using descriptive statistics. Results There was a total of 55,667 deliveries conducted during the study period. The calculated maternal mortality ratio is 129.34 per 100,000 live-births in the year 2015 to 2020. The mean age and gestational age of women with maternal deaths were 24.69 ± 5.99 years and 36.15 ± 4.38 weeks of gestation. Obstetric hemorrhage, hypertensive disorder of pregnancy and sepsis were the leading causes of maternal death. The prime contributory factors were delay in seeking health care and reaching health care facility (type I delay:40.9%). Conclusions Despite the availability of comprehensive emergency obstetric care at our center, maternal mortality is still high and almost 75% of deaths were avoidable. The leading contributory factors of maternal mortality are delay in seeking care and delayed referral from other health facilities. The avoidable causes of maternal mortality are preventable through combined safe motherhood strategies, prompt referral, active management of labor and, puerperium.

Common causes of maternal mortality based on ICD-MM: A systematic review and meta- analysis

“…The maternal mortality ratio (MMR) is a key public health indicator that quanti es the number of maternal deaths per 100,000 live births. It serves as a re ection of the quality of health services and the position and importance accorded to women in the society [7][8][9]. The global MMR has decreased signi cantly from 342 in 2000 to 211 in 2017 [10].…”

“…Identi cation of suitable strategies to prevent them is considered one of the most important programs in most countries [3][4][5].According to the WHO, "A maternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and the site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management, but not from accidental or incidental causes" [6].The maternal mortality ratio (MMR) is a key public health indicator that quanti es the number of maternal deaths per 100,000 live births. It serves as a re ection of the quality of health services and the position and importance accorded to women in the society [7][8][9]. The global MMR has decreased signi cantly from 342 in 2000 to 211 in 2017 [10].…”

Study of clinical conditions that complicated birth in women in OSH region in 2016-2021

“…Slowdowns in access to quality health care have been identified as one of the important determinants of maternal death (Chavane et al, 2018). Maternal mortality is defined as the death of a pregnant woman or within 42 days of termination of pregnancy, regardless of the date and place of pregnancy, from any cause associated with or aggravated by pregnancy or its management, but not from an accidental or accidental cause (Sitaula et al, 2021).…”

An insight into two decades of Skilled Birth Attendants in Nepal

“…Even though MMR has decreased, Nepal missed its MDG 5 target of MMR by 114. At the same time, paradoxically, maternal mortality has been increasing among institutional deliveries (2). As Nepal is in line to meet the SDG target, there is a need not just to increase institutional deliveries and consider that as an indicator for reduced maternal mortality, but also to assess the quality of care provided by SBAs.…”