International Master Programme in Public Health, Faculty of Medicine, Lund University, Malmö University Hospital, Malmö, Sweden.
BMC Public Health. 2011 Mar 10;11:159. doi: 10.1186/1471-2458-11-159.
Ghana's maternal mortality ratio remains high despite efforts made to meet Millennium Development Goal 5. A number of studies have been conducted on maternal mortality in Ghana; however, little is known about how the causes of maternal mortality are distributed in different socio-demographic subgroups. Therefore the aim of this study was to assess and analyse the causes of maternal mortality according to socio-demographic factors in Ghana.
The causes of maternal deaths were assessed with respect to age, educational level, rural/urban residence status and marital status. Data from a five year retrospective survey was used. The data was obtained from Ghana Maternal Health Survey 2007 acquired from the database of Ghana Statistical Service. A total of 605 maternal deaths within the age group 12-49 years were analysed using frequency tables, cross-tabulations and logistic regression.
Haemorrhage was the highest cause of maternal mortality (22.8%). Married women had a significantly higher risk of dying from haemorrhage, compared with single women (adjusted OR = 2.7, 95%CI = 1.2-5.7). On the contrary, married women showed a significantly reduced risk of dying from abortion compared to single women (adjusted OR = 0.2, 95%CI = 0.1-0.4). Women aged 35-39 years had a significantly higher risk of dying from haemorrhage (aOR 2.6, 95%CI = 1.4-4.9), whereas they were at a lower risk of dying from abortion (aOR 0.3, 95% CI = 0.1-0.7) compared to their younger counterparts. The risk of maternal death from infectious diseases decreased with increasing maternal age, whereas the risk of dying from miscellaneous causes increased with increasing age.
The study shows evidence of variations in the causes of maternal mortality among different socio-demographic subgroups in Ghana that should not be overlooked. It is therefore recommended that interventions aimed at combating the high maternal mortality in Ghana should be both cause-specific as well as target-specific.
尽管加纳为实现千年发展目标 5 做出了努力，但该国的孕产妇死亡率仍然很高。加纳已经开展了多项关于孕产妇死亡的研究，但对于孕产妇死亡的原因在不同社会人口亚组中的分布情况，人们知之甚少。因此，本研究旨在评估和分析根据加纳的社会人口因素，导致孕产妇死亡的原因。
根据年龄、教育程度、城乡居住状况和婚姻状况评估孕产妇死亡的原因。本研究使用了一项为期五年的回顾性调查的数据。这些数据来自加纳统计服务数据库中的 2007 年加纳孕产妇健康调查。使用频率表、交叉表和逻辑回归对年龄在 12-49 岁之间的 605 例孕产妇死亡进行了分析。
出血是导致孕产妇死亡的最主要原因（22.8%）。与单身女性相比，已婚女性因出血而死亡的风险显著更高（调整后的 OR = 2.7，95%CI = 1.2-5.7）。相反，已婚女性因流产而死亡的风险显著低于单身女性（调整后的 OR = 0.2，95%CI = 0.1-0.4）。35-39 岁的女性因出血而死亡的风险显著更高（aOR 2.6，95%CI = 1.4-4.9），而她们因流产而死亡的风险显著更低（aOR 0.3，95%CI = 0.1-0.7），与年轻女性相比。随着产妇年龄的增长，死于传染病的风险降低，而死于其他原因的风险增加。
本研究表明，加纳不同社会人口亚组中，孕产妇死亡的原因存在差异，不容忽视。因此，建议针对加纳高孕产妇死亡率的干预措施应既有针对性，也有针对性。
