[Enhanced system for maternal mortality surveillance in France, context and Methods].

Area of Science:

• Public Health
• Epidemiology
• Healthcare Quality Improvement

Background:

• Maternal mortality is a critical indicator of healthcare system performance, even in high-income countries.
• It serves as a sentinel event, signaling potential systemic dysfunctions.
• Analyzing maternal deaths offers opportunities to improve care and prevent both mortality and morbidity.

Purpose of the Study:

• To describe the methodology and evolution of France's National Confidential Enquiry into Maternal Deaths (ENCMM).
• To highlight the dual objective of epidemiological surveillance and clinical audit for maternal mortality.
• To present findings from the 2013-2015 maternal death data collection.

Main Methods:

• Multi-source identification of maternal deaths (pregnancy to one year postpartum).
• Detailed clinical data collection and assessment by expert pairs.
• Review by a National Committee of Experts for causality, care adequacy, and avoidability assessment.
• Inclusion of social context and psychiatric assessment for suicides.

Main Results:

• The ENCMM system has been adapted to enhance data completeness and documentation.
• Recent updates focus on social contexts and suicide-related maternal deaths.
• Expert review assesses the maternal nature of death, care quality, and preventability.

Conclusions:

• The ENCMM provides a robust framework for analyzing maternal deaths.
• Continuous methodological adaptation ensures comprehensive data for quality improvement.
• The system facilitates the prevention of maternal deaths and related morbidities through healthcare system enhancements.