Temporal Evolution of Maternal Mortality: 1980-2019.

Edimárlei Gonsales Valério,Maria Alexandrina Zanatta,Janete Vettorazzi,Sergio Hofmeister De Almeida Martins Costa,Mariana Hollmann Scheffler,José Geraldo Lopes Ramos

doi:10.1055/s-0041-1735300

Abstract

To determine the profile of maternal deaths occurred in the period between 2000 and 2019 in the Hospital de Clínicas de Porto Alegre (HCPA, in the Portuguese acronym) and to compare it with maternal deaths between 1980 and 1999 in the same institution. Retrospective study that analyzed 2,481 medical records of women between 10 and 49 years old who died between 2000 and 2018. The present study was approved by the Ethics Committee (CAAE 78021417600005327). After reviewing 2,481 medical records of women who died in reproductive age, 43 deaths had occurred during pregnancy or in the postpartum period. Of these, 28 were considered maternal deaths. The maternal mortality ratio was 37.6 per 100,000 live births. Regarding causes, 16 deaths (57.1%) were directly associated with pregnancy, 10 (35.1%) were indirectly associated, and 2 (7.1%) were unrelated. The main cause of death was hypertension during pregnancy (31.2%) followed by acute liver steatosis during pregnancy (25%). In the previous study, published in 2003 in the same institution4, the mortality rate was 129 per 100,000 live births, and most deaths were related to direct obstetric causes (62%). The main causes of death in this period were due to hypertensive complications (17.2%), followed by postcesarean infection (16%). Compared with data before the decade of 2000, there was an important reduction in maternal deaths due to infectious causes.

Highlights

Despite improvements in the last decades, maternal mortality remains a major global health problem
The present study aims to determine the profile of maternal deaths occurred in a tertiary care university hospital in southern Brazil from 2000 to 2019 and to compare it with the data obtained in the period from 1980 to 1999, which was analyzed in a previous study by Ramos et al.[4]
Maternal death was defined as deaths that occurred during gestation or up to 42 days after birth that were due to related causes or were aggravated by gestation or by measures taken in relation to it, as recommended by the World Health Organization (WHO)

Summary

Introduction

Despite improvements in the last decades, maternal mortality remains a major global health problem. In 2017, nearly 810 women died every day from preventable causes related to pregnancy and childbirth in the world, and there is a considerable difference in rates between developed and developing countries. The United States, for an example, had a maternal death rate of 17.4 per 100,000 live births in 2018, while in Brazil the rate was 60 per 100,000 live births in 2017. Brazil is still considered a country with a very low maternal mortality rate (< 100 per 100,000 live births) according to the WHO classification.[1]

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Discussion

Conclusion