Indirect maternal deaths

Abstract

Indirect maternal deaths account for over a quarter of maternal deaths worldwide. Deaths from indirect causes include communicable and non-communicable diseases, as well as pre-existing and new conditions. Prevention of indirect maternal deaths has received less attention than direct causes of death, where interventions can be targeted around the time of delivery. Indirect deaths can be more complex to address as pregnancy brings unique health challenges due to the changing physiology of a pregnant woman. These physiological changes are summarised alongside the impact of some communicable (e.g. malaria) and non-communicable diseases (e.g. cardiovascular disease) on indirect deaths. The challenges in diagnosing, and therefore measuring, indirect deaths are discussed, as are challenges in deciding whether these deaths are incidental or exacerbated by pregnancy. A focus on improving both research and health policy is needed to address the challenges brought about by the increasing burden of indirect deaths.