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Maternal mortality in Switzerland 1995-2004
Martina Fässler1, Roland Zimmermann, Katharina C QuackLötscher
1Klinik für Geburtshilfe, Universitätsspital Zürich, Frauenklinikstrasse 10, Zürich, Switzerland.
Swiss Medical Weekly
|July 30, 2010
Summary
Maternal mortality decreased significantly between 1995 and 2004, with hemorrhage as the leading cause. Older mothers and non-Swiss nationalities faced higher risks, highlighting areas for improved obstetric quality assurance.
Area of Science:
- Obstetrics and Gynecology
- Public Health
- Epidemiology
Background:
- Maternal mortality analysis is crucial for obstetric quality assurance.
- Periodic review of maternal deaths is essential for identifying trends and improving care.
Purpose of the Study:
- To analyze maternal mortality cases in Switzerland between 1995 and 2004.
- To identify trends, causes of death, and risk factors associated with maternal mortality.
Main Methods:
- Utilized death certificates from the Federal Statistical Office (BFS) with ICD-10 obstetric codes.
- Investigated cases from the Institute of Legal Medicine (IRM) archive in Zurich.
- Collected data via anonymous questionnaires from clinics, classifying deaths as direct, indirect, or non-pregnancy-related.
Main Results:
- Analyzed 50 maternal mortality cases; mean maternal age was 32, with 50% foreign nationality.
- Hemorrhage was the leading cause of death (13 cases), followed by thromboembolism (9 cases).
- The direct maternal mortality ratio was 4.15/100,000 live births, with an estimated underreporting of 20%.
Conclusions:
- Maternal mortality ratio decreased from 5.54 to 4.15 compared to the previous decade.
- Mortality associated with cesarean section decreased 4.5-fold.
- Older mothers and those of non-Swiss (particularly non-Western) nationality were identified as at-risk groups.
