Causes of maternal mortality
The overwhelming majority of maternal deaths occur in developing countries and arise from the risks attributable to pregnancy and childbirth as well as from the poor performance of health services. To reduce maternal deaths globally we need to assure that effective services are provided for improving overall maternal health. This task, in turn, requires targeted health care interventions that are informed by reliable and valid epidemiological data. A comprehensive summary of the magnitude and distribution of the causes of maternal deaths is therefore a critical component of a global strategy to reduce these deaths and, more broadly, to inform reproductive health policies and programs.
Methods and Expected Products
CHERG will conduct work related to causes of maternal deaths in three domains:
Estimates of causes of maternal deaths: A systematic review conducted by WHO and published in 2006 in the Lancet provides a regional distribution of causes of maternal deaths. WHO is currently in the process of updating that review with the aim of providing up-to-date global/regional/sub-regional estimates, and will be collaborating with CHERG to finalize this effort.
Estimates of individual causes and contributory factors for maternal deaths: Work in this domain aims to improve information on causes of maternal deaths by providing up-to-date estimates of incidence/ prevalence and case fatality rates of main causes of maternal deaths. Main causes of maternal deaths include, hemorrhage, pre-eclampsia/eclampsia, unsafe abortion, maternal sepsis, and indirect causes in some settings such as malaria. It is important to understand the scale and distribution of these conditions as well as case fatality rates to inform planning of interventions. Additionally, work will be conducted to understand the various contributing factors that do not directly or indirectly cause maternal deaths, but increase a woman's risks of dying from a maternal cause, such as HIV/AIDS, anemia and obstructed labor.
Classification of maternal deaths: The CHERG will contribute to the finalization of a classification system for identifying causes of maternal deaths that is being developed by RHR/HRP by supporting the write-up and dissemination of this effort.
Tunçalp O, Hindin MJ, Souza JP, Chou D, Say L. The prevalence of maternal near miss: a systematic review. BJOG. 2012 May;119(6):653-61. doi: 10.1111/j.1471-0528.2012.03294.x.