Abstract
IntroductionReduction of the maternal mortality ratio (MMR) to 12 per 100,000 live births by 2030 is a priority target in Georgia. This study aims to assess and classify MM in Georgia by direct and indirect causes of death from 2014 to 2017, using data from the national surveillance system and in accordance with internationally approved criteria. Material and methodsIn this secondary study, MM data was retrieved from the Maternal and Children’s Health Coordinating Committee and validated with data from the Vital Registry System and the Georgian Birth Registry. The study sample comprised 61 eligible MM cases. Relevant information was transferred to case-report forms to review and classify MM cases by direct and indirect causes of maternal death. ResultsThe MMR during the study period was 26.7 per 100,000 live births. The proportion of direct causes of maternal death exceeded that of indirect causes, at 62% and 38%, respectively. The leading direct cause of maternal death was haemorrhage, while infection was the most frequent indirect cause. 52.5% of MM cases had no pre-existing medical condition, 62.3% had frequent adherence to antenatal care, and 52.5% had emergency caesarean sections. ConclusionIn Georgia, direct causes of maternal death exceed indirect causes in MM cases, with haemorrhage and infections, respectively, being most common. These findings are important to ensure optimal and continuous care and to accelerate progress in the reduction of MM in the country.
Highlights
Reduction of the maternal mortality ratio (MMR) to 12 per 100,000 live births by 2030 is a priority target in Georgia
All MM cases reported to the Maternal and Children’s Health Coordinating Committee (MCHCC) during the study period (n = 84) were identified, reviewed, and validated against MM cases in the Georgian Birth Registry (GBR) and Vital Registry System (VRS) using the unique personal identification number assigned to Georgian residents/ citizens
Following the maternal death definition in the International Classification of Diseases (ICD-10), and after validation in the VRS and GBR, 23 MM cases were excluded by the study authors (12 due to late maternal death, 9 due to accidental death, and 2 due to occurrence in occupied territories in Georgia with lack of information)
Summary
Reduction of the maternal mortality ratio (MMR) to 12 per 100,000 live births by 2030 is a priority target in Georgia. This study aims to assess and classify MM in Georgia by direct and indirect causes of death from 2014 to 2017, using data from the national surveillance system and in accordance with internationally approved criteria. The leading direct cause of maternal death was haemorrhage, while infection was the most frequent indirect cause. Conclusion: In Georgia, direct causes of maternal death exceed indirect causes in MM cases, with haemorrhage and infections, respectively, being most common. These findings are important to ensure optimal and continuous care and to accelerate progress in the reduction of MM in the country. In order to reach the desired reduction in MMR, efforts must focus on the improvement of all parts of the continuum of reproductive healthcare, accurate surveillance, and understanding the causes of maternal death [2,9,10]
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