Ujah I A O, Aisien O A, Mutihir J T, Vanderjagt D J, Glew R H, Uguru V E
Department of Obstetrics and Gynaecology, Faculty of Medical Sciences, University of Jos, Jos, Nigeria.
Afr J Reprod Health. 2005 Dec;9(3):27-40.
Maternal mortality ratio in Nigeria is one of the highest in the world. This paper reports a facility based study in north-central Nigeria to determine the magnitude, trends, causes and characteristics of maternal deaths before and after the launch of the Safe Motherhood Initiative in Nigeria, with a view to suggesting strategic interventions to reduce these deaths. The records of all deliveries and case files of all women who died during pregnancy and childbirth between January 1, 1985 and December 31, 2001, in the maternity unit of Jos University Teaching Hospital, Jos, Nigeria, were reviewed. Data collected were analysed for socio-biological variables including age, booking status, educational level, parity, ethnic group, marital status, mode of delivery, duration of hospital stay before death occurred, cause (s) of maternal deaths. There were 38,768 deliveries and 267 maternal deaths during the period under review, giving a maternal mortality ratio (MMR) of 740/ 100,000 total deliveries. The trend fluctuated between 450 in 1990 and 1,010/100.000 deliveries in 1994. The mean age of maternal death was 26.4 (SD 8.1) years. The greatest risk of MMR was among young teenagers (> 15 years) and older women (< 40 years). Parity-specific maternal mortality ratio was highest in the grand multiparous women. Unbooked as well as illiterate women were associated with very high maternal mortality ratio. The Hausa - Fulani ethnic group contributed the largest number (44%) by tribe to maternal mortality in our study. The major direct causes of deaths were haemorrhage (34.6%), sepsis (28.3%), eclampsia (23.6%) and unsafe abortion (9.6%). The most common indirect causes of death were hepatitis (18.6%), anaesthetic death (14.6%), anaemia in pregnancy (14.6%), meningitis (12.0%), HIV/AIDS (10.6%) and acute renal failure (8.0%). Seventy-nine percent of the maternal deaths occurred within 24 hours of admission. Most of the deaths were preventable. A regional-specific programme should be planned to reduce the deplorably high maternal mortality in north-central Nigeria.
尼日利亚的孕产妇死亡率是世界上最高的之一。本文报告了一项在尼日利亚中北部开展的基于机构的研究，旨在确定尼日利亚安全孕产倡议启动前后孕产妇死亡的规模、趋势、原因及特征，以期提出减少这些死亡的战略干预措施。对1985年1月1日至2001年12月31日期间在尼日利亚乔斯大学教学医院产科死亡的所有孕妇和产妇的分娩记录及病例档案进行了审查。对收集的数据进行了社会生物学变量分析，包括年龄、登记状态、教育水平、产次、种族、婚姻状况、分娩方式、死亡前住院时间、孕产妇死亡原因。在审查期间共有38768例分娩，267例孕产妇死亡，孕产妇死亡率为每10万例分娩740例。这一趋势在1990年的450例和1994年的每10万例分娩1010例之间波动。孕产妇死亡的平均年龄为26.4（标准差8.1）岁。孕产妇死亡率最高的风险人群是青少年（>15岁）和年龄较大的妇女（<40岁）。多产妇的特定产次孕产妇死亡率最高。未登记以及文盲妇女的孕产妇死亡率非常高。在我们的研究中，豪萨-富拉尼族在孕产妇死亡中所占部落比例最大（44%）。主要的直接死亡原因是出血（34.6%）、败血症（28.3%）、子痫（23.6%）和不安全堕胎（9.6%）。最常见的间接死亡原因是肝炎（18.6%）、麻醉死亡（14.6%）、妊娠期贫血（14.6%）、脑膜炎（12.0%）、艾滋病毒/艾滋病（10.6%）和急性肾衰竭（8.0%）。79%的孕产妇死亡发生在入院后24小时内。大多数死亡是可以预防的。应制定一项针对该地区的计划，以降低尼日利亚中北部令人痛心的高孕产妇死亡率。
