Analysis of Causes of Maternal Death

doi:10.3877/cma.j.issn.1673-5250.2014.03.023

Objective

To analyze the causes of maternal death from 2003 to 2012 in Dianjiang County, Chongqing.

Methods

All maternal datas(74 532 cases) were collected from January 2003 to December 2012 in Dianjiang County, including 45 cases of death. A retrospective analysis had been done, which included maternal mortality rate, cause of death, death related factors and expert assessment results. The study protocol was approved by the Ethical Review Board of Investigation in Human Being of Maternal and Child Health Hospital of Dianjiang County, Chongqing.

Results

Maternal annual average mortality rate from 2003 to 2012 in whole county was 60.37/10^5, and 0/10⁵ from 2010 to 2012. The annual average mortality rate of the first five years(2003-2007) was higher than that of the last five years(2008-2012), and the difference was statistically significant(χ²=20.01, P<0.05). Main causes of death were obstetric hemorrhage (55.56%), amniotic fluid embolism (13.33%) and hypertensive disorders of pregnancy (13.33%), in turn. Maternal death may mainly be related to the low cultural level, poor health care awareness, economic difficulties, multiple births and inconvenient traffic, etc.. Assessed by experts, there were 39 cases(86.67%) of death can be avoided by creating certain conditions.

Conclusions

From 2003 to 2012, a series of interference measures had been taken by Dianjiang County municipal to ensure mother and baby's safety, which made whole county kept zero maternal mortality rate from 2010 to 2012.

Key words: Maternal mortality, Cause of death, Analysis

表1 2003－2012年垫江县孕产妇总数及孕产妇死亡率[n(×10^－5)]

Table 1 Total pregnant women numbers and maternal mortality rate from 2003 to 2012 in Dianjiang County[n(×10^－5)]

年份(年)	孕产妇总数(n)	孕产妇死亡率
2003	6 040	8(123.45)
2004	6 405	7(109.28)
2005	7 088	8(112.86)
2006	6 801	10(147.03)
2007	8 324	5 (60.06)
2008	8 414	4 (47.53)
2009	8 467	3 (35.43)
2010	8 136	0(0.00)
2011	7 225	0(0.00)
2012	7 632	0(0.00)
合计	74 532	45 (60.37)

表1 2003－2012年垫江县孕产妇总数及孕产妇死亡率[n(×10^－5)]

Table 1 Total pregnant women numbers and maternal mortality rate from 2003 to 2012 in Dianjiang County[n(×10^－5)]

年份(年)	孕产妇总数(n)	孕产妇死亡率
2003	6 040	8(123.45)
2004	6 405	7(109.28)
2005	7 088	8(112.86)
2006	6 801	10(147.03)
2007	8 324	5 (60.06)
2008	8 414	4 (47.53)
2009	8 467	3 (35.43)
2010	8 136	0(0.00)
2011	7 225	0(0.00)
2012	7 632	0(0.00)
合计	74 532	45 (60.37)

表2 2003－2012年垫江县孕产妇死亡原因及其构成比[n(%)]

Table 2 Cause of maternal death and the constituent ratio from 2003 to 2012 in Dianjiang County[n(%)]

死亡原因		2003年	2004年	2005年	2006年	2007年	2008年	2009年	2010年	2011年	2012年	合计
直接产科原因
	产科出血	3 (37.50)	5 (71.43)	7 (87.50)	5 (50.00)	2 (40.00)	2 (50.00)	1 (33.33)	0(0.00)	0(0.00)	0(0.00)	25 (55.56)
	羊水栓塞	1 (12.50)	1 (14.28)	1 (12.50)	2 (20.00)	1 (20.00)	0(0.00)	0(0.00)	0(0.00)	0(0.00)	0(0.00)	6 (13.33)
	妊娠期高血压疾病	1 (12.50)	0(0.00)	0(0.00)	2 (20.00)	1 (20.00)	1 (25.00)	1 (33.34)	0(0.00)	0(0.00)	0(0.00)	6 (13.33)
	产褥感染	0(0.00)	0(0.00)	0(0.00)	0(0.00)	0(0.00)	0(0.00)	1 (33.33)	0(0.00)	0(0.00)	0(0.00)	1(2.22)
	其他产科原因	0(0.00)	0(0.00)	0(0.00)	0(0.00)	0(0.00)	1 (25.00)	0(0.00)	0(0.00)	0(0.00)	0(0.00)	1(2.22)
间接产科原因
	心脏疾病	2 (25.00)	0(0.00)	0(0.00)	0(0.00)	0(0.00)	0(0.00)	0(0.00)	0(0.00)	0(0.00)	0(0.00)	2(4.44)
	病毒性脑炎	0(0.00)	0(0.00)	0(0.00)	1 (10.00)	0(0.00)	0(0.00)	0(0.00)	0(0.00)	0(0.00)	0(0.00)	1(2.22)
	其他疾病	1 (12.50)	1 (14.29)	0(0.00)	0(0.00)	1 (20.00)	0(0.00)	0(0.00)	0(0.00)	0(0.00)	0(0.00)	3(6.67)
合计		8(100.00)	7(100.00)	8(100.00)	10(100.00)	5(100.00)	4(100.00)	3(100.00)	0(0.00)	0(0.00)	0(0.00)	45(100.00)

表2 2003－2012年垫江县孕产妇死亡原因及其构成比[n(%)]

Table 2 Cause of maternal death and the constituent ratio from 2003 to 2012 in Dianjiang County[n(%)]

死亡原因		2003年	2004年	2005年	2006年	2007年	2008年	2009年	2010年	2011年	2012年	合计
直接产科原因
	产科出血	3 (37.50)	5 (71.43)	7 (87.50)	5 (50.00)	2 (40.00)	2 (50.00)	1 (33.33)	0(0.00)	0(0.00)	0(0.00)	25 (55.56)
	羊水栓塞	1 (12.50)	1 (14.28)	1 (12.50)	2 (20.00)	1 (20.00)	0(0.00)	0(0.00)	0(0.00)	0(0.00)	0(0.00)	6 (13.33)
	妊娠期高血压疾病	1 (12.50)	0(0.00)	0(0.00)	2 (20.00)	1 (20.00)	1 (25.00)	1 (33.34)	0(0.00)	0(0.00)	0(0.00)	6 (13.33)
	产褥感染	0(0.00)	0(0.00)	0(0.00)	0(0.00)	0(0.00)	0(0.00)	1 (33.33)	0(0.00)	0(0.00)	0(0.00)	1(2.22)
	其他产科原因	0(0.00)	0(0.00)	0(0.00)	0(0.00)	0(0.00)	1 (25.00)	0(0.00)	0(0.00)	0(0.00)	0(0.00)	1(2.22)
间接产科原因
	心脏疾病	2 (25.00)	0(0.00)	0(0.00)	0(0.00)	0(0.00)	0(0.00)	0(0.00)	0(0.00)	0(0.00)	0(0.00)	2(4.44)
	病毒性脑炎	0(0.00)	0(0.00)	0(0.00)	1 (10.00)	0(0.00)	0(0.00)	0(0.00)	0(0.00)	0(0.00)	0(0.00)	1(2.22)
	其他疾病	1 (12.50)	1 (14.29)	0(0.00)	0(0.00)	1 (20.00)	0(0.00)	0(0.00)	0(0.00)	0(0.00)	0(0.00)	3(6.67)
合计		8(100.00)	7(100.00)	8(100.00)	10(100.00)	5(100.00)	4(100.00)	3(100.00)	0(0.00)	0(0.00)	0(0.00)	45(100.00)

表3 垫江县孕产妇死亡相关因素构成比[n(%)]

Table 3 Constituent ratio of maternal death related factors in Dianjiang County[n(%)]

相关因素		构成比	相关因素		构成比	相关因素		构成比
年龄(岁)			计划生育			产前保健(次)
	20～34	9(20.00)		计划内	5(11.11)		≥3	10(22.22)
	35～45	36(80.00)		计划外	40(88.89)		1～2	14(31.11)
文化程度			居住地				0	21(46.67)
	初中	8(17.78)		城市	9(20.00)
	小学及以下	37(82.22)		农村	36(80.00)

表3 垫江县孕产妇死亡相关因素构成比[n(%)]

Table 3 Constituent ratio of maternal death related factors in Dianjiang County[n(%)]

相关因素		构成比	相关因素		构成比	相关因素		构成比
年龄(岁)			计划生育			产前保健(次)
	20～34	9(20.00)		计划内	5(11.11)		≥3	10(22.22)
	35～45	36(80.00)		计划外	40(88.89)		1～2	14(31.11)
文化程度			居住地				0	21(46.67)
	初中	8(17.78)		城市	9(20.00)
	小学及以下	37(82.22)		农村	36(80.00)

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