Taha Sara, Izzoddeen Ahmad, Munywoki Amos, Wagialla Naiema
Directorate of Mother and Child Health, GD of Primary Health Care, Federal Ministry of Health, Khartoum, Sudan.
GD of Health Emergencies and Epidemic Control, Federal Ministry of Health, Khartoum, Sudan.
BMC Public Health. 2025 May 6;25(1):1667. doi: 10.1186/s12889-025-22820-2.
Unacceptably high levels of preventable maternal deaths persist across sub-Saharan Africa. Due to limited research on maternal mortality in Sudan, a thorough examination is crucial to develop effective reduction strategies. This study aims to analyze maternal mortality trends at national and subnational levels in Sudan from 2009 to 2019.
In this retrospective-comparative study, the researchers reviewed mortality data covering 2009 to 2019 from the reports issued by the national maternal death surveillance and response. The maternal mortality ratios for the national and state levels were adjusted based on the population of women of reproductive age. The trends were assessed for statistical significance using the Mann-Kendall test, implemented in Python (version 3.12). The cut-off p-value for significance was taken as < 0.05.
The national maternal mortality ratio declined significantly by nearly 60% from 2009 to 2019 (S = -53, p < 0.001). The states of Kassala (S = -51, p < 0.001), Gadarif (S = -43, p < 0.001), Gezira (S = -41, p = 0.002), White Nile (S = -41, p = 0.002), Blue Nile (S = -39, p = 0.003), Red Sea (S = -39, p = 0.003), Khartoum (S = -39, p = 0.003), Northern State (S = -27, p = 0.043), River Nile (S = -27, p = 0.043), and Sinnar (S = -27, p = 0.043) showed significant declining trends. Blue Nile state recorded the highest average maternal mortality ratio in the study period (339.76), while Southern Darfur (66.46) and River Nile (89.59) recorded the lowest ratios. Major causes of maternal death include Obstetric hemorrhage (45.5%), hypertensive disorders (16%), and sepsis (12.6%). Important characteristics of pregnancy-related death include condition at admission, gestational age, antenatal care, mode of delivery, and areas of delay.
The national maternal mortality ratio significantly declined between 2009 and 2019, with wide regional disparities. Direct causes of maternal death remain a critical challenge. Effective strategies or frameworks focused on reducing maternal mortality ratios in Sudan are strongly solicited.
撒哈拉以南非洲地区可预防的孕产妇死亡水平高得令人无法接受。由于苏丹对孕产妇死亡率的研究有限，进行全面调查对于制定有效的降低策略至关重要。本研究旨在分析2009年至2019年苏丹全国和次国家级层面的孕产妇死亡率趋势。
在这项回顾性比较研究中，研究人员审查了国家孕产妇死亡监测与应对报告中涵盖2009年至2019年的死亡率数据。根据育龄妇女的人口数量对国家和州层面的孕产妇死亡率进行了调整。使用Python（版本3.12）中实现的曼-肯德尔检验评估趋势的统计学显著性。显著性的临界p值设定为<0.05。
2009年至2019年，全国孕产妇死亡率显著下降了近60%（S = -53，p < 0.001）。卡萨拉州（S = -51，p < 0.001）、加达里夫州（S = -43，p < 0.001）、杰济拉州（S = -41，p = 0.002）、白尼罗州（S = -41，p = 0.002）、青尼罗州（S = -39，p = 0.003）、红海州（S = -39，p = 0.003）、喀土穆州（S = -39，p = 0.003）、北州（S = -27，p = 0.043）、尼罗河州（S = -27，p = 0.043）和森纳尔州（S = -27，p = 0.043）呈现出显著下降趋势。青尼罗州在研究期间记录的平均孕产妇死亡率最高（339.76），而南达尔富尔州（66.46）和尼罗河州（89.59）记录的死亡率最低。孕产妇死亡的主要原因包括产科出血（45.5%）、高血压疾病（16%）和败血症（12.6%）。与妊娠相关死亡的重要特征包括入院时状况、孕周、产前护理、分娩方式和延误环节。
2009年至2019年期间，全国孕产妇死亡率显著下降，但存在广泛的地区差异。孕产妇死亡的直接原因仍然是一项严峻挑战。强烈呼吁制定侧重于降低苏丹孕产妇死亡率的有效策略或框架。
