Abstract
To determine the causes and characteristics of maternal deaths in HIV-infected women. A retrospective study of maternal deaths in a cohort of HIV-infected women. A facility-based maternal death review using case records and mortality summaries. Thirty seven maternal deaths which occurred in HIV-infected women were reviewed in a university teaching hospital in southern Nigeria over a 4-year period. Causes and circumstances surrounding each maternal death were identified. One in every four maternal deaths occur in women with HIV infection. Majority (64.9%) of the women presented in advanced stage (WHO stage III/IV) of HIV syndrome while 86.5% had missed opportunities for antiretroviral programme. Pregnancy-related sepsis was the commonest cause of maternal death. Other common causes were death from tuberculosis and pneumonia. HIV-related maternal death is emerging as a leading cause of pregnancy related death in Nigeria. There is need to scale-up preconception care and ensure comprehensive and sustainable prevention of mother -to-child transmission service for all pregnant women throughout Nigeria to reduce the burden of HIV/AIDS infection and minimize avoidable deaths from opportunistic infections.
Highlights
The HIV pandemic remains a major health challenge facing the world
The recent sero-sentinel survey put the HIV infection rate at 4.6% in 2008.3 Available statistics indicate that Nigeria currently has one of the highest rates of maternal mortality in the developing world; with evidence suggesting that maternal mortality ratio in the country has reached an all-time high of 1,100 per 100,000 live-births.[4]
To the best of our knowledge from available electronic literature search, this audit represents the only published information on maternal deaths in a cohort of HIV-infected subjects in the West African sub-region. This was a facility based maternal death review conducted at the obstetric unit of the University of Benin Teaching Hospital (UBTH), an urban tertiary health centre which serves as referral centre for a population
Summary
Of the estimated 33.2 million people living with HIV worldwide, more than two-thirds (22.5 million) live in sub-Saharan Africa, where women of childbearing age are most severely affected.[1] The scourge of the virus has ravaged the region’s population with untold negative impacts on demographic, economic and social spheres as well as severe adverse effects on women’s health.2In Nigeria, inspite of all efforts to combat the disease, HIV/AIDS remains a major public health problem with an estimated 4.6% (2.95 million) of the population infected with the virus; one of the highest number in the world. To the best of our knowledge from available electronic literature search, this audit represents the only published information on maternal deaths in a cohort of HIV-infected subjects in the West African sub-region
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