Original researchPreventability of maternal deaths: comparison between Zambian and American referral hospitals1
Section snippets
Materials and methods
Using the World Health Organization (WHO) criteria, a maternal death was defined as the death of a woman while pregnant or within 42 days of termination of pregnancy, and only pregnancy-related (direct and indirect) maternal deaths were evaluated. Direct maternal deaths were defined as deaths from diseases or complications that occur only during pregnancy such as abortion, eclampsia, or ectopic pregnancy. Indirect deaths were defined as deaths resulting from a disease process not directly
Results
At KGH, 108 maternal deaths occurred between 1998 and 1999. Total live births during this time were 7014, resulting in an institution-derived MMR of 1540 per 100,000 live births. From 1992 to 2000, within the UIC Perinatal Network, 33 pregnancy-related maternal deaths were identified, and 161,814 live births occurred, resulting in an MMR of 20.4 per 100,000 live births.
In the UIC network, the maternal age distribution of the deaths was as follows: 64% of women were aged 20–34 years, 24% were 35
Discussion
The most striking difference in maternal deaths between the Zambian and American referral hospitals was the staggering difference in rate of deaths. The MMR (1540) for KGH is likely to be elevated because many births occur at home in Zambia. However, although these MMRs were determined from single referral institutions, their justification is supportable. In Zambia, the published MMRs were derived from the Sisterhood method, which is an indirect way of estimating maternal deaths from the
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The authors wish to thank Jordan Greenberg, PhD, for providing statistical assistance.