A 3-year retrospective review of mortality in women of reproductive age in a tertiary health facility in Port Harcourt, Nigeria

Abstract

PurposeTo determine the causes of death and associated risk factors among women of reproductive age (WRA) in a tertiary institution in Port Harcourt, Nigeria.Patients and methodsThis was a retrospective survey of all deaths in women aged 15–49 years at the University of Port Harcourt Teaching Hospital that occurred from January 1, 2013 to December 31, 2015. Data retrieved from ward registers, death registers, and death certificates were analyzed with Epi Info version 7. Comparison of socioeconomic and demographic risk factors for maternal and nonmaternal deaths was done using a multivariate logistic regression model.ResultsThere were 340 deaths in the WRA group over the 3-year period. The majority (155 [45.6%]) of the women were aged 30–39 years. There were 265 (77.9%) nonmaternal deaths and 75 (22.1%) maternal deaths. Among the nonmaternal deaths, 124 (46.8%) had infectious diseases, with human immunodeficiency virus being the most common cause of infection in this group. Breast cancer (13 [4.9%]), cervical cancer (12 [4.5%]), and ovarian cancer (11 [4.2%]) were the most common malignant neoplasms observed. Hypertensive disorders of pregnancy (31 [41.3%]) and puerperal sepsis (20 [26.7%]) were the most common causes of maternal deaths. Age and occupation were significantly associated with deaths in WRA (p<0.05). Older women aged >30 years (odd ratio =1.86, 95% CI =1.07–3.23) and employed women (odds ratio =2.55, 95% CI =1.46–4.45) were more likely to die from nonmaternal than maternal causes.ConclusionMost of the deaths were nonmaternal. Infectious diseases, diseases of the circulatory system, and malignant neoplasms were the major causes of death among WRA, with maternal deaths accounting for approximately a quarter. Public health programs educating women on safer sex practices, early screening for cancers, benefits of antenatal care, and skilled attendants at delivery will go a long way to reducing preventable causes of deaths among these women.

Risk factors, changes in serum inflammatory factors, and clinical prevention and control measures for puerperal infection

“…Puerperal infection is a common and frequently occurring disease in clinic, which is also a common postpartum complication in puerperae. Its clinical manifestations mainly include elevated postpartum temperature accompanied by chills, lower abdominal pain, and tenderness, and severe infection displayed in biochemical examination . During the delivery process, changes in the physiological structure of pregnant women, hemorrhage, delivery injury, etc, lead to the decline in the body's immunity, resulting in puerperal infection under the action of some risk factors .…”

“…accompanied by chills, lower abdominal pain, and tenderness, and severe infection displayed in biochemical examination 7. During the delivery process, changes in the physiological structure of pregnant women, hemorrhage, delivery injury, etc, lead to the decline in the body's immunity, resulting in puerperal infection under the action of some risk factors 8.…”

Cardiovascular System Mortalities in Nigeria; Case Study of the University of Port Harcourt Teaching Hospital

“…Obiorah and Amachree in their systemic analysis of sudden natural deaths at the Brathwaite Memorial Specialist Hospital (BMSH) Port Harcourt, reported that diseases of the cardiovascular system accounted for 87.6% of the sudden natural deaths autopsied [20]. In another 3-year retrospective review of mortality in women of reproductive age in UPTH, hypertensive disorders in pregnancy accounted for 41.3% of the deaths [21]. Besides, other similar studies carried out in Umuahia South Eastern Nigeria [22] and Ile-Ife South Western, Nigeria [23] also reported that DCVS were the commonest systemic causes of deaths in the respective tertiary hospital centres.…”

Relationship between urban planning and flooding in Port Harcourt city, Nigeria; insights from planning professionals

“…Port Harcourt is a coastal city in the heart of the Niger Delta area of Nigeria (see Figure 2). It is the capital of Rivers state which boasts Nigeria's largest oil and gas reserves making it a city of great economic importance (Orazulike et al, 2017). Port Harcourt is Nigeria's fourth largest city after Lagos (Southwest), and regional centres Kano (Northwest) and Ibadan (Southwest).…”