E Karalis1, V-M Ulander1, A-M Tapper1,2, M Gissler3,4. 1. Department of Obstetrics and Gynecology, University of Helsinki, Helsinki University Hospital, Helsinki, Finland. 2. University of Helsinki, Hyvinkää Hospital, Hyvinkää, Finland. 3. THL, National Institute for Health and Welfare, Helsinki, Finland. 4. Department of Neurobiology, Care Sciences and Society, Division of Family Medicine, Karolinska Institute, Stockholm, Sweden.
Abstract
OBJECTIVE: To investigate mortality in the non-pregnant fertile female population, and mortality during pregnancy and up to 1 year after the end of pregnancy, in Finland from 2001 to 2012 and compare the results with those of 1987-2000. DESIGN: Retrospective cohort study. SETTING: Finland. POPULATION: 10 427 deceased women of reproductive age (15-49). METHODS: Pregnancy outcomes were categorised into: ongoing pregnancy or birth, miscarriage or ectopic pregnancy and termination of pregnancy. Mortality was calculated per 100 000 pregnancies. The mortality rate of the non-pregnant female population of fertile age was calculated per 100 000 person-years, and the results were compared with those of 1987-2000. MAIN OUTCOME MEASURES: Pregnancy-associated mortality during pregnancy and up to 1 year after the end of pregnancy. Mortality of non-pregnant, fertile-age, female population. RESULTS: The age-adjusted mortality rate during pregnancy and within 1 year after the end of pregnancy was 28.4/100 000 pregnancies, and it had significantly decreased compared with the period 1987-2000 [risk ratio (RR) 0.75 (95% CI, 0.65-0.88)]. Mortality in non-pregnant fertile-age females was 48.1/100 000 person-years. Mortality for diseases and medical conditions during and after pregnancy decreased by 26% [RR 0.74 (95% CI, 0.59-0.92)] and for external causes by 23% [RR 0.77 (95% CI, 0.62-0.95)]. The mortality rate for suicides was 3.3/100 000 in ongoing pregnancies and pregnancies ending in birth while it was 21.8/100 000 after termination of pregnancy and 10.2/100 000 among non-pregnant women. CONCLUSIONS: In comparison with earlier decades, pregnancy-associated mortality has decreased in Finland. TWEETABLE ABSTRACT: Mortality decreases among pregnant women and within 1 year after pregnancy in Finland.
OBJECTIVE: To investigate mortality in the non-pregnant fertile female population, and mortality during pregnancy and up to 1 year after the end of pregnancy, in Finland from 2001 to 2012 and compare the results with those of 1987-2000. DESIGN: Retrospective cohort study. SETTING: Finland. POPULATION: 10 427 deceased women of reproductive age (15-49). METHODS: Pregnancy outcomes were categorised into: ongoing pregnancy or birth, miscarriage or ectopic pregnancy and termination of pregnancy. Mortality was calculated per 100 000 pregnancies. The mortality rate of the non-pregnant female population of fertile age was calculated per 100 000 person-years, and the results were compared with those of 1987-2000. MAIN OUTCOME MEASURES: Pregnancy-associated mortality during pregnancy and up to 1 year after the end of pregnancy. Mortality of non-pregnant, fertile-age, female population. RESULTS: The age-adjusted mortality rate during pregnancy and within 1 year after the end of pregnancy was 28.4/100 000 pregnancies, and it had significantly decreased compared with the period 1987-2000 [risk ratio (RR) 0.75 (95% CI, 0.65-0.88)]. Mortality in non-pregnant fertile-age females was 48.1/100 000 person-years. Mortality for diseases and medical conditions during and after pregnancy decreased by 26% [RR 0.74 (95% CI, 0.59-0.92)] and for external causes by 23% [RR 0.77 (95% CI, 0.62-0.95)]. The mortality rate for suicides was 3.3/100 000 in ongoing pregnancies and pregnancies ending in birth while it was 21.8/100 000 after termination of pregnancy and 10.2/100 000 among non-pregnant women. CONCLUSIONS: In comparison with earlier decades, pregnancy-associated mortality has decreased in Finland. TWEETABLE ABSTRACT: Mortality decreases among pregnant women and within 1 year after pregnancy in Finland.