[Factors associated with maternal deaths at Tengandogo University Hospital, Ouagadougou, Burkina Faso, 2017-2022]

Burkina Faso ranks among the African countries with high maternal mortality rates, with a ratio of 198 per 100,000 live births. Maternal health remains a major concern in this country. Several factors contribute to this mortality rate. Our study aimed to identify factors associated with maternal deaths at Tengandogo University Hospital, a referral hospital in Burkina Faso.

This was a retrospective case-control study. We selected records pertaining to women admitted to the maternity and intensive care units between January 1, 2017, and December 31, 2022. The cases included all women admitted for a pregnancy-related complication who subsequently died. The control group was randomly selected from women admitted for childbirth and/ or pregnancy-related complications during the study period who did not die during pregnancy or within 42 days after delivery. Our sample consisted of one case for every two controls. Logistic regression was used to identify associated factors.

A total of 146 deaths were recorded, but 124 cases (22 records were unusable) and 248 controls were analyzed. The indoor maternal mortality ratio was 1,960 per 100,000 live births (146/7,450). The mean age of the women who died was 28.5 ± 7.1 years. Of those women, 73 (58.9%) lived in rural areas, 109 (87.9%) were unemployed, 118 (84.7%) were referred from a primary or secondary health facility, 106 (89.1%) were transported by ambulance, 67 (54%) were multiparous, and 68 (57.1%) delivered vaginally. Preeclampsia/eclampsia was present in 15% of the women and retroplacental hematoma (RPH) was present in 13%. The factors independently associated with maternal death were RPH (OR = 4.6, 95% CI [1.6-12.7]), ambulance transport (OR = 3.8, 95% CI [1.9-7.9]), and vaginal delivery (OR = 2.6, 95% CI [1.5-4.5]).

The indoor maternal mortality rate is high. It is necessary to strengthen obstetricians' skills in the early detection of RPH and hemorrhage management. Improving the ability to detect complications during prenatal care and labor and delivery is also essential for better obstetric decision-making. The Ministry of Health should ensure adequate conditions for patient evacuation.