Background: Pakistan has experienced a significant reduction in maternal mortality with a decline of 33 percent between 2006 and 2019. However, the country still grapples with a high number (186 per 100,000 live births) of maternal deaths each year. This study aims to identify socio-demographic and health system related factors associated with maternal mortality.
Methods: Using the nested case-control design, we conducted an in-depth analysis of Pakistan Maternal Mortality Survey (PMMS) 2019. We identified 147 maternal deaths occurring within three years prior to the PMMS 2019 as "cases" and 724 women who gave birth and were alive during the same period as "controls". Socio-demographic characteristics of cases and controls were compared, and multivariate regression was employed to investigate the predictors of maternal mortality in Pakistan.
Results: Cases and controls were similar on access to antenatal care (ANC) and ANC provider but differed on age, education, number of pregnancies, type of delivery, tetanus toxoid vaccination during last pregnancy, and contraceptive usage. A higher proportion of cases had deliveries by skilled birth attendants (83% compared to 63% among controls) while home deliveries were more common among controls (32% compared to 25% among cases). Odds of maternal death were lowest among women aged 20-29 years (odds ratio-OR: 0.5; 95% CI 0.23-1.07) and those with secondary or higher education (OR: 0.35; 95% CI 0.17-0.74). Surprisingly, deliveries attended by skilled birth attendants were associated with higher odds of maternal death (OR: 4.07; 95% CI 2.19-7.57) compared to those who were not.
Conclusion: This study identifies secondary or higher maternal education, having had tetanus injection during the last pregnancy, ever-used contraception or being in the age group of 20-29 years were factors associated with lower risk of maternal mortality. Conversely, skilled birth attendance increases the risk of maternal death in Pakistan. Further investigation is needed into the determinants of high maternal mortality.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11698442 | PMC |
| http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0290492 | PLOS |
Publication Analysis
Top Keywords
Similar Publications
Predicting purulent meningitis in very preterm infants: a novel clinical model.
BMC Pediatr
January 2025
Department of Pediatrics, Qilu Hospital, Shandong University, No.107, West Culture Road, Lixia District, Jinan City, Shandong Province, 250000, China.
Background: Purulent meningitis (PM) is a commonly encountered infectious condition in newborns, which unfortunately can result in infant mortality. Newborns with PM often present nonspecific symptoms. The success of lumbar puncture, an invasive test, relies on the operator's expertise.
View Article and Find Full Text PDFA lack of sexual autonomy is associated with increased loneliness in young mothers.
BMC Womens Health
January 2025
Department of Neuroscience, Physiology and Pharmacology, University College London, 21 University Street, London, WC1E 6DE, UK.
Background: Loneliness is a significant risk factor for both mental and physical health issues, including depression and increased mortality. Loneliness is reported at higher levels during life transitions, such as the transition to motherhood. Loneliness in mothers has far-reaching detrimental impacts on both mother and child, such as an increased risk of maternal depression and child abuse.
View Article and Find Full Text PDFSevere maternal morbidity contributed by obstetric hemorrhage: Maryland, 2020-2022.
Am J Obstet Gynecol MFM
January 2025
Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St Suite E8527, Baltimore, MD 21205; Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St Suite E8527, Baltimore, MD 21205; Department of Gynecology and Obstetrics, Johns Hopkins School of Medicine, 550 North Broadway Baltimore, MD 21205.
Background: Obstetric hemorrhage is the leading cause of maternal mortality and severe maternal morbidity (SMM) in Maryland and nationally. Currently, through a quality collaborative, the state is implementing the Alliance for Innovation on Maternal Health (AIM) patient safety bundle on obstetric hemorrhage.
Objective: To describe SMM events contributed by obstetric hemorrhage and their preventability in Maryland.
Risk of severe maternal morbidity and mortality among pregnant patients with chronic kidney disease: Renal disease and severe maternal morbidity.
Am J Obstet Gynecol MFM
January 2025
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Cincinnati College of Medicine, 231 Albert Sabin Way, Cincinnati, Ohio 45267, USA. Electronic address:
Background: Chronic kidney disease is a significant cause of adverse obstetric outcomes. However, there are few studies assessing the risk of severe maternal morbidity and mortality among patients with chronic kidney disease and no studies assessing the association between individual indicators of severe maternal morbidity and chronic kidney disease.
Objective: To evaluate the risk of severe maternal morbidity and mortality among pregnant patients with chronic kidney disease.
Using routine data to examine factors associated with stillbirth in three tertiary maternity facilities in Kabul, Afghanistan.
Reprod Health
January 2025
Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium.
Background: Over one-third of the global stillbirth burden occurs in countries affected by conflict or a humanitarian crisis, including Afghanistan. Stillbirth rates in Afghanistan remained high in 2021 at over 26 per 1000 births. Stillbirths have devastating physical, psycho-social and economic impacts on women, families and healthcare providers.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!