Background: Nigeria has one of the worst global maternal mortality ratios (MMR). Institutional audit is invaluable in providing useful information for formulating preventive interventions.
Objective: To evaluate the trends, causes and socio-demographic characteristics of maternal mortality at a tertiary institution in South-western Nigeria over a period of 13 years (2007-2019).
Methodology: Cross sectional and temporal trend analysis of maternal deaths were conducted using chart reviews from 2007 to 2019. Socio-biological characteristics, booking status and ranking of clinical causes of maternal deaths were derived from patients' chart review (2007-2019). Bivariate analysis and Annual percent change (APC) of the observed trends was respectively conducted using Stata version 17 and Joinpoint version 4.5.0.1 software respectively.
Results: In the period 2007-2019, the mean age at maternal death was 30.8 ± 5.9 years and 88.8% of mortalities occurred among the "unbooked" women. The leading causes of direct maternal mortality were Hypertension (27.0%), Sepsis (20.6%) and haemorrhage (18.7%), while anaemia in pregnancy (3.2%), Human Immunodeficiency Virus (3.2%) and Sickle Cell Disease (2.4%) were the leading indirect causes of maternal mortality Joinpoint estimates showed a statistically significant increase in MMR of about 3.4% per annum from 2211 per 100,000 live births in 2007 to 3555.6 per 100,000 live births in 2019 (APC: +3.4%, P-value < 0.001).
Conclusion: Contrary to some other reports, there was an increase in the institutional MMR between 2007 and 2019 even though the leading causes of death remained similar. Targeted interventions based on accurate data are urgently required in order to achieve the Sustainable Development Goal (SDG) 3.1.
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http://dx.doi.org/10.1186/s12884-022-04649-4 | DOI Listing |
Syst Rev
January 2025
Department of Epidemiology, Mailman School of Public Health, Columbia University Irving Medical Center, New York, NY, USA.
Background: Impaired intrauterine growth, a significant global health problem, contributes to a higher burden of infant morbidity and mortality, mainly in resource-poor settings. Maternal anemia and undernutrition, two important causes of impaired intrauterine growth, are prioritized by global nutrition targets of 2030. We synthesized the evidence on the role of preconception nutrition supplements in reducing maternal anemia and improving intrauterine growth.
View Article and Find Full Text PDFPLoS One
January 2025
Public Health Department (MNCH), Health Services Academy, Islamabad, Islamabad Capital Territory, Pakistan.
Background: Maternal mortality ratio (MMR) has decreased worldwide but Pakistan is still striving towards achieving the SDG targets for maternal health. This study highlights the trends in maternal mortality levels and risk factors in Pakistan between 2007 and 2019.
Methods: This study compares the results of secondary data analysis of the Pakistan Maternal Mortality Survey 2019 with the Pakistan Demographic and Health Survey 2007.
JAMA Netw Open
January 2025
Harvard School of Public Health, Boston, Massachusetts.
Importance: Improving access to high-quality maternity care and reducing maternal morbidity and mortality are major policy priorities in the US. Previous research has primarily focused on access to general obstetric care rather than access to high-risk pregnancy care provided by maternal-fetal medicine subspecialists (MFMs).
Objective: To measure access to MFM services and determine patient factors associated with MFM service use, including MFM telemedicine.
Int J Gynaecol Obstet
January 2025
Department of Medicine, Ladoke Akintola University of Technology, Ogbomoso, Nigeria.
Pre-eclampsia remains a significant health challenge in sub-Saharan Africa, contributing substantially to maternal and neonatal mortality rates. This paper explores the potential of low-dose calcium supplementation as an alternative strategy to the conventional high-dose regimen in preventing pre-eclampsia. A consistent association between low serum calcium levels and an increased risk of pre-eclampsia is established based on studies spanning Ghana, Nigeria, and Ethiopia.
View Article and Find Full Text PDFAfrican-American women have a maternal mortality rate approximately three times higher than European-American women. This is partially due to hypertensive disorders of pregnancy, including preeclampsia. Fetal high-risk genotype increases preeclampsia risk, although mechanisms remain elusive.
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