Frequency and Risk Factors Associated with Mortality in Pregnant Women in Tehran-Iran

Abstract

<p><strong>BACKGROUND &amp; OBJECTIVES:</strong> Ending mortality in pregnant women is not just a health challenge, but a development challenge. The purpose of this study was to access the frequency and risk factors associated with maternal mortality in Tehran from 2008 to 2011.</p><p><strong>METHODS: </strong>The present study was a case-control study with a population group which consists of all the women who have died since the beginning of pregnancy up to 42 days after delivery from the year 2008 to 2011 and a control group which consists of all delivered pregnant women with a perfect record in the hospitals (n=16) in Tehran from 2008 to 2011. In the case group, sampling was done through census (n = 113) and random sampling was used in the control group and 327 people were selected. Data collection tool was a record sheet consisting of two parts: demographic and risk factors associated with pregnancy which was completed using the data in the case and control groups. Finally, SPSS 22, descriptive statistics and statistical tests such as Chi-square, t-test and Fisher were used to analyze the data.</p><p><strong>RESULTS:</strong> Maternal deaths were reported in Tehran from 2008 to 2011 and the ratio was 15.8 in 100 thousand of live births during the period. Among the mothers who died, 73.5% of them were 18 to 34 years old, 1.22% were 35 years old or above and only 4.4% were less than 18 years of age. Of these mothers that died, 83.2% lived in the city and 16.8% lived in rural areas, but there were significant relationship between age, place of residence and maternal deaths. In combination with other risk factors, such as pregnancy age, pregnancy number, number of abortions, underlying medical condition, access to appropriate prenatal care, methods of delivery, factors of delivery, and the time may be between two last pregnancy, a significant difference was observed between the case and control groups, except for the distance between the two last pregnancy.</p><p><strong>CONCLUSION: </strong>Maternal mortality has been declining over the years; due to the identified factors associated with maternal death, proposed strategies, such as improving the quality of hospital services in the field of obstetric emergencies, improving the quality and coverage of prenatal care, avoidance of selective cesarean sections, identifying high risk pregnancies and referrals to specialized centers.</p>