OBJECTIVE: To perform a comprehensive assessment of maternal mortality in Argentina, the ultimate purpose being to strengthen the surveillance system and reorient reproductive health policies to prevent maternal deaths. METHODS: Our multicentre population-based study combining qualitative and quantitative methodologies included a descriptive analysis of under-registration and distribution of causes of death, a case-control study to identify risk factors in health-care delivery and verbal autopsies to analyse social determinants associated with maternal deaths. FINDINGS: A total of 121 maternal deaths occurred during 2002. The most common causes were abortion complications (27.4%), haemorrhage (22.1%), infection/sepsis (9.5%), hypertensive disorders (8.4%) and other causes (32.6%). Under-registration was 9.5% for maternal deaths (n = 95) and 15.4% for late maternal deaths (n = 26). The probability of dying was 10 times greater in the absence of essential obstetric care, active emergency care and qualified staff, and doubled with every 10-year increase in age. Other contributing factors included delays in recognizing "alarm signals"; reluctance in seeking care owing to desire to hide an induced abortion; delays in receiving timely treatment due to misdiagnosis or lack of supplies; and delays in referral/transportation in rural areas. CONCLUSION: A combination of methodologies is required to improve research on and understanding of maternal mortality via the systematic collection of health surveillance data. There is an urgent need for a comprehensive intervention to address public health and human rights issues in maternal mortality, and our results contribute to the consensus-building necessary to improve the existing surveillance system and prevention strategies.
OBJECTIVE: To perform a comprehensive assessment of maternal mortality in Argentina, the ultimate purpose being to strengthen the surveillance system and reorient reproductive health policies to prevent maternal deaths. METHODS: Our multicentre population-based study combining qualitative and quantitative methodologies included a descriptive analysis of under-registration and distribution of causes of death, a case-control study to identify risk factors in health-care delivery and verbal autopsies to analyse social determinants associated with maternal deaths. FINDINGS: A total of 121 maternal deaths occurred during 2002. The most common causes were abortion complications (27.4%), haemorrhage (22.1%), infection/sepsis (9.5%), hypertensive disorders (8.4%) and other causes (32.6%). Under-registration was 9.5% for maternal deaths (n = 95) and 15.4% for late maternal deaths (n = 26). The probability of dying was 10 times greater in the absence of essential obstetric care, active emergency care and qualified staff, and doubled with every 10-year increase in age. Other contributing factors included delays in recognizing "alarm signals"; reluctance in seeking care owing to desire to hide an induced abortion; delays in receiving timely treatment due to misdiagnosis or lack of supplies; and delays in referral/transportation in rural areas. CONCLUSION: A combination of methodologies is required to improve research on and understanding of maternal mortality via the systematic collection of health surveillance data. There is an urgent need for a comprehensive intervention to address public health and human rights issues in maternal mortality, and our results contribute to the consensus-building necessary to improve the existing surveillance system and prevention strategies.
Authors: C Stanton; J Hobcraft; K Hill; N Kodjogbé; W T Mapeta; F Munene; M Naghavi; V Rabeza; B Sisouphanthong; O Campbell Journal: Bull World Health Organ Date: 2001 Impact factor: 9.408
Authors: J Villar; H Ba'aqeel; G Piaggio; P Lumbiganon; J Miguel Belizán; U Farnot; Y Al-Mazrou; G Carroli; A Pinol; A Donner; A Langer; G Nigenda; M Mugford; J Fox-Rushby; G Hutton; P Bergsjø; L Bakketeig; H Berendes; J Garcia Journal: Lancet Date: 2001-05-19 Impact factor: 79.321
Authors: Ariel Karolinski; Agustina Mazzoni; José M Belizán; Fernando Althabe; Eduardo Bergel; Pierre Buekens Journal: Int J Gynaecol Obstet Date: 2010-06-03 Impact factor: 3.561
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Authors: Lachmi R Kodan; Kim J C Verschueren; Jos van Roosmalen; Humphrey H H Kanhai; Kitty W M Bloemenkamp Journal: BMC Pregnancy Childbirth Date: 2017-08-29 Impact factor: 3.007