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Maternal mortality in Sweden, 1980-1988
U Högberg1, E Innala, A Sandström
1Department of Obstetrics and Gynecology, Umeå University, Sweden.
Obstetrics and Gynecology
|August 1, 1994
Summary
Maternal mortality in Sweden (1980-1988) was low, with advanced age and suboptimal care as key risk factors. Regular reviews and improved death registration are vital for monitoring maternal health.
Area of Science:
- Obstetrics and Gynecology
- Public Health
- Epidemiology
Background:
- Maternal mortality rates vary globally, necessitating accurate classification for effective monitoring.
- Sweden has historically maintained low maternal mortality, but continuous assessment is crucial.
Purpose of the Study:
- To evaluate maternal mortality in Sweden using different International Classification of Diseases (ICD) definitions.
- To identify trends and causes of maternal deaths during 1980-1988.
Main Methods:
- Comprehensive data retrieval from Swedish Medical Birth Registry and Registers of Births and Deaths.
- Inclusion of hospital records and autopsy reports for detailed case analysis.
- Application of ICD-9 criteria for classifying maternal deaths.
Main Results:
- The maternal mortality ratio was 7.4 per 100,000 live births (ICD-9).
- Direct maternal deaths (n=36) were primarily caused by embolism, hemorrhage, preeclampsia, and infection.
- Advanced maternal age was a significant risk factor, with suboptimal care contributing to nearly one-third of direct deaths.
- Late maternal deaths (n=76) were often due to malignancy, stroke, and heart disease; suicide was a leading cause post-malignancy.
Conclusions:
- Ongoing maternal mortality reviews are essential, even in low-mortality settings.
- Utilizing updated ICD classifications enhances international comparability of maternal mortality data.
- Integrated birth and death registration systems are critical for continuous surveillance of maternal and pregnancy-related deaths.