Trends in maternal mortality in Switzerland among Swiss and foreign nationals, 1969-2006

To test whether maternal mortality was higher among immigrant women than Swiss women.

All maternal deaths and live births in Switzerland from 1969 to 2006 from official vital statistics were considered. We calculated maternal mortality ratios (MMRs) in four time intervals (1969-1979, 1980-1989, 1990-1999, 2000-2006) for both Swiss and immigrant women overall, and for Italian, Spanish and Turkish women. We also computed the odds ratios and 95% confidence intervals of maternal mortality over the four time periods, considering maternal deaths as cases, and live births as controls.

From 1969 to 2006 there were 279 maternal deaths, 204 of Swiss women and 75 of immigrant women. Women's age, marital status and cause of death were similar in the two groups. For immigrant women, the crude odds ratio of a pregnancy ending with maternal death, not homogeneous across the four periods, was 4.38 (95% CI 1.88-10.55) in 2000-2006.

Immigrant women have a higher risk of maternal mortality than Swiss women. A closer scrutiny of risk factors and quality of care is necessary to identify opportunities for prevention.