Bouvier-Colle M-H, Deneux C, Szego E, Couet C, Michel E, Varnoux N, Jougla E
INSERM, Unité 149, Recherches épidémiologiques en santé périnatale et santé de la reproduction, Maternité Hôpital Tenon, 4, rue de la Chine, 75020 Paris.
J Gynecol Obstet Biol Reprod (Paris). 2004 Sep;33(5):421-9. doi: 10.1016/s0368-2315(04)96550-7.
Ten years after implementation of maternal mortality monitoring in France, we established a new estimate of the current maternal mortality ratio (MMR) and revisited maternal death data collection.
Linkages were set up between female deaths and childbirths and between female deaths and causes of death. Information provided by confidential inquiries into maternal deaths carried out by the National Committee for maternal mortality study was added. The World Health Organization (WHO) definitions were used for maternal death and maternal mortality ratio. The study concerned deaths occurring in 1999. Results were compared with data from 1989.
The official data showed 20% fewer maternal deaths than our inquiry. Estimated from our data, the MMR was 9 per 100000 live births in 1999. Direct obstetric causes were more often recorded than indirect causes. Hemorrhage was the leading obstetric cause of maternal death (21%). In comparison with the 1989-90 data, the underestimation of maternal deaths and maternal mortality ratios are improving (from 18 to 9 per 100000).
These results, obtained while the mean maternal age at childbirth increased regularly, are interpreted as a sign of improvement in care. But the persistence of post partum hemorrhages as the leading cause of maternal death and the high rate of avoidable deaths, disclose important targets for further progress.
在法国实施孕产妇死亡监测十年后，我们对当前的孕产妇死亡率（MMR）进行了新的估算，并重新审视了孕产妇死亡数据的收集情况。
建立了女性死亡与分娩之间以及女性死亡与死因之间的关联。添加了由国家孕产妇死亡率研究委员会对孕产妇死亡进行的保密调查所提供的信息。采用世界卫生组织（WHO）对孕产妇死亡和孕产妇死亡率的定义。该研究涉及1999年发生的死亡情况。将结果与1989年的数据进行了比较。
官方数据显示的孕产妇死亡人数比我们的调查结果少20%。根据我们的数据估算，1999年的孕产妇死亡率为每10万例活产9例。直接产科原因的记录比间接原因更为常见。出血是孕产妇死亡的主要产科原因（21%）。与1989 - 1990年的数据相比，孕产妇死亡和孕产妇死亡率的低估情况正在改善（从每10万例18例降至9例）。
这些结果是在分娩时的平均孕产妇年龄持续增加的情况下获得的，被解读为护理改善的迹象。但产后出血作为孕产妇死亡的主要原因持续存在以及可避免死亡的高比例，揭示了进一步取得进展的重要目标。
