Indirect maternal deaths: UK and global perspectives
Manisha Nair1, Catherine Nelson-Piercy2, Marian Knight1
1National Perinatal Epidemiology Unit, University of Oxford, Oxford, UK.
Obstetric Medicine
|May 12, 2017
Summary
Indirect maternal deaths, often due to pre-existing conditions, are rising globally. Improved care coordination and research are crucial for reducing these preventable deaths in pregnant women.
Area of Science:
- Obstetrics and Gynecology
- Public Health
- Epidemiology
Background:
- Indirect maternal deaths, defined as deaths from pre-existing conditions exacerbated by pregnancy, are a significant concern, particularly in high-income countries.
- There's a notable increase in indirect maternal deaths in low- to middle-income countries, linked to rising non-communicable diseases in women of reproductive age.
- Despite overall reductions in maternal mortality, indirect deaths remain a persistent challenge, with no significant decrease in the UK since 2003.
Purpose of the Study:
- To analyze indirect maternal deaths in the UK.
- To provide a perspective on causes, trends, and care issues related to indirect maternal deaths in low- to middle-income countries.
- To highlight the need for evidence-based, multidisciplinary care for pregnant women with medical comorbidities.
Main Methods:
- Review of indirect maternal deaths in the UK.
- Analysis of causes and trends in low- to middle-income countries.
- Identification of care gaps and contributing factors.
Main Results:
- Indirect maternal deaths accounted for 68% of all maternal deaths in the UK in 2011-2013, with cardiac disease being the leading cause.
- Key care issues include unclear responsibility for patient management and inadequate follow-up.
- Under-reporting and misclassification are prevalent in low- to middle-income countries, leading to underestimated mortality rates.
- Communicable diseases, non-communicable diseases, and nutritional disorders are major causes of indirect death.
Conclusions:
- A steady increase in indirect maternal deaths due to pre-existing conditions necessitates urgent attention.
- Improved clarity in medical responsibility and enhanced healthcare access are vital for better maternal outcomes.
- Further research into risk factors and management of medical comorbidities during pregnancy is essential for evidence-based care.
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