President of International Academy of Perinatal Medicine, Zagreb, Croatia.
Department of Obstetrics and Gynecology Medical School, University of Zagreb, Neonatal Unit, Clinical Hospital "Sv. Duh", Zagreb, Croatia.
J Perinat Med. 2022 Jun 1;51(2):170-181. doi: 10.1515/jpm-2022-0061. Print 2023 Feb 23.
Maternal death is defined as the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and the site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management. Maternal mortality (MM) and morbidity are a public health issue, with scarce knowledge on their levels and causes in low-income (LIC) countries. The data on MM and morbidity should rely on population-based studies which are non-existent. Therefore, maternal mortality ratio (MMR) estimates are based mostly on the mathematical models. MMR declined from 430 per 100,000 live births (LB) in 1990 to 211 in 2017. Absolute numbers of maternal deaths were 585,000 in 1990, 514,500 in 1995 and less than 300,000 nowadays. Regardless of reduction, MM remains neglected tragedy especially in LIC. Millennium Development Goals (MDGs) declared reduction MMR by three quarters between 2000 and 2015, which failed. Target of Sustainable Development Goals (SDGs) was to decrease MMR to 70 per 100,000 LB. Based on the data from the country report on SDGs in 10 countries with the highest absolute number of maternal deaths it can be concluded that the progress has not been made in reaching the targeted MMR. To reduce MMR, inequalities in access to and quality of reproductive, maternal, and newborn health care services should be addressed, together with strengthening health systems to respond to the needs and priorities of women and girls, ensuring accountability to improve quality of care and equity.
产妇死亡定义为妇女在妊娠期间或妊娠终止后 42 天内，无论妊娠持续时间和地点如何，由与妊娠或其管理有关或因妊娠或其管理而加重的任何原因导致的死亡。孕产妇死亡率（MM）和发病率是一个公共卫生问题，对于低收入国家（LIC）的水平和原因知之甚少。关于 MM 和发病率的数据应依赖于不存在的基于人群的研究。因此，孕产妇死亡率（MMR）的估计主要基于数学模型。MMR 从 1990 年的每 10 万活产儿（LB）430 例下降到 2017 年的 211 例。1990 年孕产妇死亡人数为 58.5 万，1995 年为 51.45 万，现在不到 30 万。尽管有所减少，但 MM 仍然是一个被忽视的悲剧，尤其是在 LIC。千年发展目标（MDGs）宣布 2000 年至 2015 年期间将 MMR 减少四分之三，但未能实现。可持续发展目标（SDGs）的目标是将 MMR 降至每 10 万 LB 70 例。根据孕产妇死亡人数最高的 10 个国家的 SDG 国家报告中的数据，可以得出结论，在实现目标 MMR 方面没有取得进展。为了降低 MMR，应解决获得生殖、孕产妇和新生儿保健服务的机会不平等以及加强卫生系统以满足妇女和女童的需求和优先事项的问题，确保问责制以提高护理质量和公平性。
