Maternal Mortality Ratio and Predictors of Maternal Deaths in Selected Desert Districts in Rajasthan

Gupta, Shiv Dutt; Khanna, Anoop; Gupta, Rajeshwari; Sharma, Nand K.; Sharma, Narottam D.

doi:10.1016/j.whi.2009.10.003

Cited by 39 publications

(29 citation statements)

References 6 publications

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“…Pregnancy complications were not associated with mortality in our study, different from another case–control study of maternal mortality, in India [28] and the known risks of poor obstetric management [14,15,29,30]. The difference may reflect the high proportion of cases for which the deceased women’s status on this variable was “unknown” (among 81 cases who died after delivery, data on this variable was not available for 33).…”

Section: Discussioncontrasting

confidence: 84%

Maternal deaths among rural–urban migrants in China: a case–control study

Zhang

et al. 2014

BMC Public Health

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BackgroundDisparity in maternal mortality exists between rural–urban migrant and urban resident women in China, but little research has provided evidence for related policy development. The objective of this study was to identify associations with and risks for maternal death among rural–urban migrant women in order to improve health services for migrant women and reduce maternal mortality in China.MethodsWe conducted a prospective case–control study in urban areas of Guangdong, Zhejiang and Fujian provinces and Beijing municipality. In each, migrant women who died between July 1, 2010 and October 1, 2011 were identified through reports from China’s Maternal and Child Mortality Surveillance System. For each, four matched controls were selected from migrant women who delivered in local hospitals during the same period. We compared socio-demographic characteristics, health status and health service variables between cases and controls, and used bivariate and multivariate conditional logistic regression analyses to determine associations with and risk factors for maternal death.Results109 cases and 436 controls were assessed. Family income <2000 yuan per month (OR = 4.5; 95% CI 1.7-11.7) and lack of health insurance (OR = 1.3; 95% CI 1.1-1.6) were more common amongst women who died, as were lack of antenatal care (ANC) (OR = 22.3; 95% CI 4.3-116.0) and attending ANC only 1–4 times (OR = 5.0; 95% CI 1.6-15.5). Knowledge of danger signs during delivery was less common in this group (OR = 0.3; 95% CI 0.1-0.8).ConclusionDifferences existed between migrant women who died in pregnancy and surviving controls. The identified risk factors suggest strategies for health sector and community action on reducing maternal mortality among migrant women in China. A systematic approach to maternity care for rural–urban migrant women is recommended.

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Section: Discussioncontrasting

confidence: 84%

Maternal deaths among rural–urban migrants in China: a case–control study

Zhang

et al. 2014

BMC Public Health

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“…Fawole and collaborators in a similar setting in Nigeria found having had 4 or more deliveries an independent predictor of maternal mortality of deliveries in health facilities [23]. Our study did not identify other independent predictors of in-facility maternal mortality identified by other authors such as having had a cesarean section or being an adolescent [23], [27]. Authors attribute the excess maternal mortality risk in adolescent mothers to socioeconomic factors rather than mother’s age [28].…”

Section: Discussioncontrasting

confidence: 61%

Outcome of deliveries among adolescent girls at the Yaoundé central hospital

Fouelifack

Tameh

Mbong

et al. 2014

BMC Pregnancy Childbirth

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BackgroundAdolescent pregnancies are a growing public health problem in Cameroon. We sought to study the outcome of such pregnancies, in order to inform public health action.MethodsA cross-sectional analysis of 5997 deliveries which compared the outcome of deliveries in adolescent (10–19 years old) pregnant women registered at the Yaoundé Central Hospital between 2008 and 2010 to that of their non-adolescent adult (≥ 20 years old) counterparts. Variables used for comparison included socio-demographic and obstetric characteristics of parturients, referral status, and maternal and fetal outcomes. Predictors of maternal and of perinatal mortality were determined through binomial logistic modeling.ResultsAdolescent deliveries represented 9.3% (560) of all pregnancies registered. Adolescent pregnancies had significantly higher rates of both gestational duration extremes: preterm as well as post-term deliveries (29.3% versus 24.5%, p = 0.041 OR 1.28 95% CI 1.01-1.62 and 4.9 versus 2.4%, p = 0.014 OR 2.11 95% CI 1.46-3.87 respectively). Both groups did not differ significantly with respect to mean blood loss, rates of cesarean or instrumental deliveries. Adolescent deliveries however required significantly twice as many episiotomies (OR 2.15 95% CI 1.59-2.90). The likelihood of perineal tears in the adolescent group was significantly higher than that in the adult group on assuming episiotomies done would have been tears if they had not been carried out (OR 1.45 95% CI 1.16-1.82). Adolescent parturients had a higher likelihood of apparent fetal death at birth as well as perinatal fetal death after resuscitation efforts (AOR 1.75 95% CI 1.25-2.47 and AOR 1.69 95% CI 1.17-2.45 respectively).Comparisons of pregnancy outcomes between early (10–14 years), middle (15–17 years) and late adolescence (18–19 years) found no significant differences. Predictors of maternal death included having been referred, having had ≥5 deliveries and preterm deliveries. These were also predictors of perinatal death, as well as being a single mother, primiparous, and multiple gestations.ConclusionsAdolescent pregnancies in Cameroon compared to those in adults are associated with poorer outcomes. There is need for adolescent-specific services to prevent teenage pregnancies as well as interventions to prevent and manage the above mentioned predictors of in-facility maternal and perinatal mortality.

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“…Maternal deaths continue to be concentrated among poor women (WHO, 2012). A case control study from rural Rajasthan for instance, shows a 5 times higher risk of maternal mortality among women belonging to the poor household as compared to the women of non-poor households (Gupta, 2010;Jain, 2016). The national health portal also classified the socio-economic conditions of the family as one of the primary reasons for high maternal mortality rate in the country (Jayabalan, 2015).…”

Section: Socio-economic Disparitymentioning

confidence: 99%

Maternal Mortality in India: An Overview of social causes

Singh¹,

Puri²,

Chopra³

2018

IJSRP

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Abstract-Reducing maternal mortality has been a constant struggle globally. Although developed regions have shown a steep decline in maternal deaths, developing world continues to contribute inordinately to the total maternal deaths. The Millennium Development Goal (MDG) 'five' focused on reducing maternal mortality and achieving universal access to reproductive health care. In lieu of that, India has made extensive efforts to achieve the same, which are visible through the sharp increase in the rate of institutional births (NFHS 4), but the concurrent high incidences of maternal mortality present a contradictory picture of the nation's progress in improving maternal health. Despite of the boom in the medical and health sector that India has witnessed in the past decades, progress in reducing maternal mortality at the national level is disappointing. With new Sustainable Development Goal (SDG) to reduce maternal mortality ratio to 70 per 100,000 live births by the year 2030, India needs to move beyond the hospital-based approach in addressing the reproductive health issues. The determinants of maternal mortality need to be studied through the lens of social phenomenon to understand its multidimensional nature. The present review, thus, briefly explores the available evidences to determine the causes of maternal mortality operating from proximate to distant level.

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Maternal Mortality Ratio and Predictors of Maternal Deaths in Selected Desert Districts in Rajasthan

Cited by 39 publications

References 6 publications

Maternal deaths among rural–urban migrants in China: a case–control study

Maternal deaths among rural–urban migrants in China: a case–control study

Outcome of deliveries among adolescent girls at the Yaoundé central hospital

Maternal Mortality in India: An Overview of social causes

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