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Related Experiment Videos

Maternal mortality: only 42 days?

Lars Høj1, Domingos da Silva, Kathryn Hedegaard

  • 1Projecto de Saúde de Bandim, Danish Epidemiology Science Centre, Apartado 861, Bissau, Guinea-Bissau.

BJOG : an International Journal of Obstetrics and Gynaecology
|November 1, 2003
PubMed
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Maternal mortality in Guinea-Bissau persists beyond 42 days postpartum. Extending the definition of maternal death to three months could increase estimates by 10-15% in harsh living conditions.

Area of Science:

  • Global Health
  • Reproductive Health
  • Epidemiology

Background:

  • The World Health Organization (WHO) defines maternal death as occurring within 42 days of pregnancy termination.
  • This definition may underestimate mortality in settings with prolonged recovery periods due to persistent health issues like anemia and infection risk.
  • Harsh living conditions in developing countries can exacerbate postpartum health burdens.

Purpose of the Study:

  • To investigate the duration of excess mortality after delivery in rural Guinea-Bissau.
  • To assess whether the standard 42-day definition of maternal death adequately captures postpartum mortality.
  • To inform potential revisions of maternal mortality definitions.

Main Methods:

  • A prospective cohort study followed 15,844 women of childbearing age over six years.

Related Experiment Videos

  • Biannual visits and verbal autopsies were used to determine cause and timing of death relative to pregnancy termination.
  • Mortality rates were calculated for specific short time intervals post-delivery or miscarriage.

    • Main Results:

    • 194 deaths were eligible for analysis following registered pregnancies.
    • Eighty-two deaths occurred within the first 42 days postpartum.
    • Significant excess mortality was observed between 43-91 days (RR = 2.8) and 7-12 months postpartum (15.9 times higher than baseline).

    Conclusions:

    • Pregnancy and delivery significantly impact women's health for longer than 42 days in environments with harsh living conditions.
    • The current WHO definition likely underestimates pregnancy-related mortality.
    • Expanding the maternal death definition to three months postpartum could increase estimates by 10-15%.