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Maternal morbidity and mortality: an iceberg phenomenon
S Leitao1, E Manning1, R A Greene1
1National Perinatal Epidemiology Centre, University College Cork, Cork, Ireland.
BJOG : an International Journal of Obstetrics and Gynaecology
|August 29, 2021
Summary
Maternal morbidity in Ireland is primarily caused by hemorrhage and hypertension, despite their low fatality rates. Prevention efforts for these conditions need increased focus to improve maternal health outcomes.
Area of Science:
- Obstetrics and Gynecology
- Public Health
- Epidemiology
Background:
- Maternal morbidity and mortality remain significant global health concerns.
- Understanding the incidence and patterns of major causes is crucial for effective intervention.
Purpose of the Study:
- To apply the iceberg model to quantify the incidence of hemorrhage, hypertension, sepsis, and thrombosis in maternal morbidity and mortality in Ireland.
- To analyze absolute and relative incidence rates for these conditions.
Main Methods:
- Secondary analysis of national data on maternal morbidity and mortality in the Republic of Ireland.
- Inclusion of approximately 715,000 maternities and 2,138 cases of severe maternal morbidity (SMM).
- Calculation of incidence rates and case-fatality ratios.
Main Results:
- Hemorrhage and hypertension disorders are leading causes of maternal morbidity, with high hospitalization rates.
- Despite high incidence, case-fatality rates for hemorrhage and hypertension are very low, suggesting effective management.
- For every maternal death due to thrombosis, there were 35 pulmonary embolism cases and 257 hospitalizations.
Conclusions:
- Hemorrhage and hypertension disorders are the primary drivers of maternal morbidity in Ireland.
- While management appears effective, greater emphasis on prevention of these conditions is necessary.
- The findings highlight the need for timely interventions and a focus on preventing both severe and non-severe maternal morbidities.
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