The increasing importance of extragenital pathology in the structure of maternal mortality in Russia

Abstract

to determine the proportion of direct obstetric and indirect extragenital causes of maternal deaths in Russia in recent years. Official statistical data on maternal mortality in Russia were analyzed according to the criteria of the 10th revision of the International Classification of Diseases and compared with those in European countries and the USA. In the past 10 years, Russia has registered a gradual decline in the single maternal mortality rate: 27.7 in 2005, 18.6 in 2010, 12.9 in 2013, 11.9 in 2014, 10.7 in 2015, and 8.3 in 2016 per 100,000 live births. This was mainly due to a substantial decrease in obstetric losses and to the expansion of a network of well-equipped perinatal centers. Stabilization of the proportion of extragenital causes was simultaneously found. Among them in 2014, cardiovascular diseases were a dominant cause of death (51.7%), followed by respiratory diseases (29.8%) and digestive diseases and other conditions (18.2%). The demographic, socioeconomic, and medical conditions for extragenital causes were analyzed and compared with those in European countries and the USA. Recommendations were given to improve the postmortem analysis of maternal deaths in Russia. It is necessary to improve the postmortem diagnosis of the direct and indirect causes of maternal deaths and to ensure the quality and completeness of autopsies in deceased women.