Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
Bam University of Medical Sciences, Bam, Iran.
Arch Iran Med. 2022 Sep 1;25(9):578-590. doi: 10.34172/aim.2022.93.
Since 1990, maternal mortality ratio (MMR) has significantly decreased in Iran. However, estimates for mortality and morbidity by cause at subnational scale are not available.
This study is part of the Global Burden of Diseases study (GBD) 2019. Here we report maternal mortality and morbidity by age and cause across 31 provinces of Iran from 1990 to 2019.
Since 1990, MMR declined from 44.5 (95% UI: 38.6-50.1) to 15.9 (14.7-17.3) per 100000 live births in Iran. In 1990 MMR ranged from 18.5 (11.2-26.4) to 76.9 (38.4-114.7) per 100000 live births across provinces. Respective figures for 2019 were 7.1 (5.2-9.3) to 34.0 (25.1-44.7) per 100000 live births. In 2019, MMR was higher in young women (aged 10 to 14) and older women (aged 45 or more). Percentages of deaths under 25 years was 24.8% in 1990 and 16.0% in 2019. There was remarkable decline in years lost due to premature death (YLL) rates from 1990 to 2019. While the decline was modest for years lived with disability (YLD) rates. Indirect maternal deaths and other maternal deaths ranked first or second in almost all provinces. Ultimately, there was an evident decrease in MMR along with increase in socio-demographic Index (SDI) from 1990 to 2019 in all provinces and an evident convergence across provinces.
MMR has declined to levels much lower than Sustainable Development Goals in all provinces. Although there was a convergence in trends, there are still disparities across provinces. The decline in disabilities caused by maternal disorders is not as significant as mortality, which needs further actions.
自 1990 年以来，伊朗的产妇死亡率（MMR）显著下降。然而，在国家以下各级别，按病因分类的死亡率和发病率的估计数尚不可用。
本研究是 2019 年全球疾病负担研究（GBD）的一部分。在这里，我们报告了 1990 年至 2019 年伊朗 31 个省份按年龄和病因分类的产妇死亡率和发病率。
自 1990 年以来，伊朗的 MMR 从每 10 万活产 44.5（95%UI：38.6-50.1）下降到 15.9（14.7-17.3）。1990 年，各省的 MMR 范围为每 10 万活产 18.5（11.2-26.4）至 76.9（38.4-114.7）。2019 年相应的数字为每 10 万活产 7.1（5.2-9.3）至 34.0（25.1-44.7）。2019 年，年轻妇女（10-14 岁）和老年妇女（45 岁及以上）的 MMR 较高。1990 年 25 岁以下人群的死亡百分比为 24.8%，2019 年为 16.0%。1990 年至 2019 年，由于过早死亡（YLL）导致的损失年数（YLL）显著下降。而由于残疾（YLD）导致的损失年数的下降幅度较小。间接产妇死亡和其他产妇死亡在几乎所有省份都排名第一或第二。最终，1990 年至 2019 年，所有省份的 MMR 随着社会人口发展指数（SDI）的增加而明显下降，各省之间的差距也在缩小。
所有省份的 MMR 都下降到远低于可持续发展目标的水平。尽管趋势趋同，但各省之间仍存在差异。产妇疾病导致的残疾下降程度不如死亡率显著，这需要进一步采取行动。
