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1. Direct deaths - result from obstetric complications of the pregnant state (pregnancy,
labour and puerperium), from interventions, omissions, incorrect treatment or from a
chain of events resulting from any of the above e.g. eclampsia, amniotic fluid embolism,
rupture of the uterus, postpartum haemorrhage.
2. Indirect deaths - result from pre-existing disease or disease that developed during
pregnancy and which was not due to direct obstetric causes, but which was aggravated by
the physiological effects of pregnancy e.g. heart disease, diabetes, renal disease.
3. Incidental deaths - result from conditions occurring during pregnancy, where the
pregnancy is unlikely to have contributed significantly to the death, though there could
still be a distant association, for example road accidents or some malignancies.
An estimated 289 000 women died in 2013 due to complications in pregnancy and
childbirth, down from 523 000 in 1990.
more than 1 in 4 maternal deaths are caused by pre-existing medical conditions such as
diabetes, HIV, malaria and obesity, whose health impacts can all be aggravated by
pregnancy.
o A related WHO study of causes of more than 60 000 maternal deaths in 115
countries caused 28% of the deaths.
similar to the proportion of deaths during pregnancy and childbirth from severe bleeding.
o severe bleeding (mostly during and after childbirth) 27%
o pregnancy-induced high blood pressure 14%
o infections 11%
o obstructed labour and other direct causes 9%
o abortion complications 8%
o blood clots (embolism) 3%.
Australia
2006-2010
Maternal deaths in Australia 2006-2010[1]
Over the five years 2006-2010, there were 99 maternal deaths in Australia according to the
report, Maternal deaths in Australia 2006-2010. This equates to a rate of 6.8 deaths per 100,000
women who gave birth in Australia. While lower than the rates for the previous three year
reporting period 2003-2005 (8.4 deaths per 100,000 women who gave birth), and 2000-2002
(11.1 deaths per 100,000 women who gave birth), trends should be interpreted with caution due
to the small numbers and the rare occurrence of these deaths.
In 2006-2010 there were 39 direct maternal deaths and 57 indirect deaths. Three deaths were not
able to be classified as direct or indirect.
leading causes of direct maternal death included embolism (a blockage of major blood
vessels) caused by amniotic fluid (accounting for 9 deaths) or blood clot (8), and
haemorrhage (7).
leading cause of indirect maternal death was cardiac disease (15 deaths), followed by
deaths due to psychosocial morbidity (related to mental health and substance abuse
issues) (13 deaths).
women who died were aged between 17 and 45 years, with women aged over 40 being at
higher risk of maternal death.
A higher number of previous pregnancies was also associated with increased risk, as was
residing in Remote or Very remote areas.
Indigenous women were about three times as likely to die as non-Indigenous women,
with a maternal mortality rate of 16.4 deaths per 100,000 women giving birth (9 deaths).
Sepsis and cardiac conditions have been the leading causes of maternal death among
Indigenous women over the period 1997 to 2010.
2003-2005
Data shown below from the most recent triennial report "Maternal deaths in Australia 2003-
2005".[2]
Over the three years, 65 deaths were classified as directly or indirectly relating to the pregnancy
or its management, with all deaths occurring while the women were pregnant, or within 42 days
of termination of pregnancy. During the triennium, one woman died for every 11,896 women
giving birth, giving a maternal death ratio of 8.4 per 100,000 of women giving birth. This
compares favourably with the reported Maternal Mortality Rates (MMR) in other developed
countries (WHO 2007).
Indigenous results are the great exception=
Maternal mortality rates for Aboriginal or Torres Strait Islander women were more than two and
a half times as high as for other women. There were 21.5 deaths per 100,000 women giving
birth, versus 7.9 per 100,000 for non-Indigenous women. This high rate is consistent with
previous reports. The lack of improvement indicates that further measures are needed to improve
the pregnancy outcomes for Aboriginal and Torres Strait Islander women.
cardiac disease
psychiatric related causes
non- obstetric haemorrhage
United Kingdom
Saving Mothers' Lives: Reviewing maternal deaths to make motherhood safer:
2006-2008. The Eighth Report of the Confidential Enquiries into Maternal
Deaths in the United Kingdom
PMID 21356004
PMID 21757549
References
1.
Johnson S, Bonello MR, Li Z, Hilder L & Sullivan EA. 2014. Maternal deaths in Australia
2006-2010. Maternal deaths series no. 4. Cat. no. PER 61. Canberra: AIHW. AIHW
2. Sullivan EA, Hall B & King J F 2008. Maternal deaths in Australia 2003-2005.
Maternal deaths series no. 3. Cat. no. PER 42. Canberra: AIHW. Viewed 25 June 2014
<http://www.aihw.gov.au/publication-detail/?id=6442468086>.
Terms
lifetime risk of maternal death - is the probability of both becoming pregnant and the
probability of dying as a result of that pregnancy cumulated across a woman’s
reproductive years.
maternal mortality rate - is the number of maternal deaths in a given period per
100,000 women of reproductive age during the same period, reflects the frequency with
which women are exposed to risk of death through fertility.
maternal mortality ratio - is the number of maternal deaths during a given period per
100,000 live births during the same period. This is a measure of the risk of death once a
woman has become pregnant.
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WHO - Trends in Maternal Mortality 1990 to 2013 | Trends in Maternal Mortality 1990
to 2015
Australian Institute of Health and Welfare - Maternal deaths in Australia 2003-2005