Incidence and characteristics of maternal mortality: a retrospective study in Dhaka medical college

Mohammad Khayrul Bashar Khan; Asma Sarker; M. Shahinur Rahman; M. Khairul Kabir Khan; Israt Jahan Sarna

doi:10.18203/2320-1770.ijrcog20241418

Authors

Mohammad Khayrul Bashar Khan Department of Gynaecology and Obstetrics, 250 Bed General Hospital, Jamalpur, Bangladesh
Asma Sarker Department of Gynaecology and Obstetrics, Sheikh Hasina Medical College Hospital, Jamalpur, Bangladesh
M. Shahinur Rahman Department of Gynaecology and Obstetrics, Sheikh Hasina Medical College Hospital, Jamalpur, Bangladesh
M. Khairul Kabir Khan Department of Anaesthesiology, Mymensingh Medical College Hospital, Mymensingh, Bangladesh
Israt Jahan Sarna Department of Obstetrics and Gynaecology, Barhatta Upazila Health Complex, Netrokona, Bangladesh

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20241418

Keywords:

Maternal mortality, Eclampsia, Obstetric haemorrhage, Antenatal care

Abstract

Background: Maternal mortality remains a significant public health challenge globally, particularly in low-resource settings like Bangladesh. This study aims to analyze the incidence and characteristics of maternal mortality at Dhaka Medical College Hospital, a major tertiary care center in Bangladesh.

Methods: This retrospective observational study was conducted, reviewing 10,592 birth records from July 2009 to June 2010. The study focused on maternal deaths during this period, identifying 189 cases. Data on age, socioeconomic status, parity, antenatal care practices, and causes of mortality were analyzed

Results: The maternal mortality rate was found to be 1.78%. The majority of deaths occurred in younger women, with 25.40% in the 16-20 age group and 36.51% in the 21-25 age group. A significant majority (80.95%) of the deaths occurred among women from low socioeconomic backgrounds. Regarding parity, the highest mortality was observed in women with 1-2 children (39.68%). Antenatal care was notably deficient, with 75.66% of participants not receiving any. The leading causes of maternal mortality were eclampsia (31.75%) and obstetric haemorrhage (30.16%).

Conclusions: The study highlights a high incidence of maternal mortality among younger women and those from low socioeconomic backgrounds, with eclampsia and obstetric haemorrhage being the predominant causes. The lack of antenatal care is a critical concern. These findings underscore the need for improved antenatal care services, emergency obstetric care, and targeted interventions to address socioeconomic disparities in maternal health.

Metrics

Metrics Loading ...

References

Trends in maternal mortality 2000 to 2017: estimates by WHO, UNICEF, UNFPA, World Bank Group and the United Nations Population Division. Available at: https://iris.who.int/handle/10665/327595. Accessed on 20 November 2023.

Say L, Chou D, Gemmill A, Tunçalp Ö, Moller AB, Daniels J, et al. Global causes of maternal death: a WHO systematic analysis. Lancet Global Health. 2014;2(6):e323-33.

Shaw SY, du Plessis E, Broers R, Vasavithasan S, Hamdani S, Avery L. Correlates of maternal, newborn and child health services uptake, including male partner involvement: Baseline survey results from Bangladesh. Global Public Health. 2023;18(1):224.

Antsaklis A. Maternal Mortality: What are Women Dying from? Donald J Ultrasound Obstet Gynecol. 2020;14(1):64-9.

Ahmed T, Rahman AE, Amole TG, Galadanci H, Matjila M, Soma-Pillay P, et al. The effect of COVID-19 on maternal newborn and child health (MNCH) services in Bangladesh, Nigeria and South Africa: call for a contextualised pandemic response in LMICs. Int J Equity Health. 2021;20(1):77.

Omidakhsh N, von Ehrenstein OS. Improved water, sanitation and utilization of maternal and child health services in south Asian analysis of demographic health surveys. Int J Environ Res Public Health. 2021; 18(14):7667.

Borsha FH, Rudra S, Naher L. An empirical analysis of socioeconomic risk factors associated with antenatal care attendance in Bangladesh. Multidiscip Sci J. 2024;6(4):202.

Patrick M, Zaman MS uz, Afzal G, Mahsud M, Hanifatu MN. Factors That Affect Maternal Mortality in Rwanda: A Comparative Study with India and Bangladesh. Computat Math Method Med. 2022.

Calvert C, John J, Nzvere FP, Cresswell JA, Fawcus S, Fottrell E, et al. Maternal mortality in the covid-19 pandemic: findings from a rapid systematic review. Global Health Action. 2021;14(1):1974677.

Lestari I, Saudah N, Lukita Dewi CP. Literature Review: Analysis to Reduce Maternal Mortality. JNK J. 2022;9(2):261-9.

Horwood G, Opondo C, Choudhury SS, Rani A, Nair M. Risk factors for maternal mortality among 1.9 million women in nine empowered action group states in India: secondary analysis of Annual Health Survey data. BMJ. 2020;10(8):e038910.

Arunda M, Emmelin A, Asamoah BO. Effectiveness of antenatal care services in reducing neonatal mortality in Kenya: analysis of national survey data. Glob Health Action. 2017;10(1):1328796.

Hlongwa M, De WN. Demographic and socioeconomic factors associated with under-5 mortality in KwaZulu-Natal, South Africa. South Afr J Child Health. 2019;13(4):174-9.

Maternal mortality ratio (per 100 000 live births). Available at: https://www.who.int/data/gho/data/indicators/indicator-details/GHO/maternal-mortality-ratio-(per-100-000-live-births). Accessed on 20 November 2023.

Ganchimeg T, Ota E, Morisaki N, Laopaiboon M, Lumbiganon P, Zhang J, et al. Pregnancy and childbirth outcomes among adolescent mothers: a World Health Organization multicountry study. BJOG. 2014;121:40-8.

Bangladesh Demographic and Health Survey. Available at: https://dhsprogram.com/publications/ publication-fr311-dhs-final-reports.cfm. Accessed on 20 November 2023.

Moller AB, Petzold M, Chou D, Say L. Early antenatal care visit: a systematic analysis of regional and global levels and trends of coverage from 1990 to 2013. Lancet Glob Health. 2017;5(10):e977-83.

Alkema L, Chou D, Hogan D, Zhang S, Moller AB, Gemmill A, et al. Global, regional, and national levels and trends in maternal mortality between 1990 and 2015, with scenario-based projections to 2030: a systematic analysis by the UN Maternal Mortality Estimation Inter-Agency Group. Lancet. 2016; 387(10017):462-74.

WHO recommendations on antenatal care for a positive pregnancy experience. Available at: https://iris.who.int/handle/10665/250796. Accessed on 20 November 2023.

Ganatra B, Gerdts C, Rossier C, Johnson BR, Tunçalp Ö, Assifi A, et al. Global, regional, and subregional classification of abortions by safety, 2010–14: estimates from a Bayesian hierarchical model. Lancet. 2017;390(10110):2372-81.