Fathi Najafi Tahereh, Dashti Sareh, Naghsh Ali, Saboor Parsa Maryam
Department of Midwifery, Faculty of Nursing and Midwifery, Mashhad Medical Sciences, Islamic Azad University, Mashhad, Iran.
Department of Public Health, Faculty of Paramedicine, Mashhad Medical Sciences, Islamic Azad University, Mashhad, Iran.
Arch Public Health. 2024 Dec 18;82(1):237. doi: 10.1186/s13690-024-01466-3.
Maternal mortality is among the main indicators of health in nations. Identifying the causes of maternal mortality is crucial in designing preventive interventions. Therefore, this study aimed to evaluate the causes of maternal mortality during 8 years.
This descriptive-analytical study was conducted on the archived cases of maternal mortality in the Forensic Medicine Department of the Khorasan Razavi Province between March 2013 and March 2022, but as no data was available for the first two years, maternal mortality data for 8 years was evaluated. Demographic characteristics, midwifery data, pregnancy care method, pregnancy care and delivery agent, insurance type, and confirmed cause of death were compared between the first and last five-year periods of the study.
Overall, 250 cases of maternal mortality were identified in the study period. The prevalence of indirect and unrelated causes of maternal mortality was significantly higher in the last four-year period compared to the first four-year period (p < 0.001). The most common direct causes of maternal mortality in both periods were postpartum hemorrhage, eclampsia and gestational hypertension complications; and postpartum infection. Coronavirus disease 2019 (COVID-19) was the most common cause of maternal mortality in the last four-year period but the other common indirect causes of maternal mortality (cardiovascular disease and pulmonary embolism) were similar between the two periods. The most common unrelated cause of maternal mortality was accidents.
Postpartum maternal mortality was higher than intrapartum period. Bleeding was still the main cause of maternal mortality. Despite the progress in prenatal care, it is necessary to improve intrapartum and postpartum quality of care.
孕产妇死亡率是各国健康状况的主要指标之一。确定孕产妇死亡原因对于设计预防干预措施至关重要。因此，本研究旨在评估8年间孕产妇死亡的原因。
本描述性分析研究对2013年3月至2022年3月期间呼罗珊拉扎维省法医部门存档的孕产妇死亡病例进行，但由于前两年没有数据，因此对8年的孕产妇死亡数据进行了评估。比较了研究的前五年和后五年期间的人口统计学特征、助产数据、妊娠护理方法、妊娠护理和分娩代理、保险类型以及确诊的死亡原因。
总体而言，在研究期间共确定了250例孕产妇死亡病例。与前四年相比，后四年期间孕产妇死亡的间接和非相关原因的患病率显著更高（p < 0.001）。两个时期孕产妇死亡最常见的直接原因是产后出血、子痫和妊娠期高血压并发症以及产后感染。2019冠状病毒病（COVID-19）是后四年期间孕产妇死亡最常见的原因，但两个时期孕产妇死亡的其他常见间接原因（心血管疾病和肺栓塞）相似。孕产妇死亡最常见的非相关原因是事故。
产后孕产妇死亡率高于产时。出血仍然是孕产妇死亡的主要原因。尽管产前护理取得了进展，但仍有必要提高产时和产后的护理质量。
