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Causes of Maternal Mortality from 1980 to 2013

on Mon, 05/30/2016 - 01:38

Maternal death is the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes. To facilitate the identification of maternal deaths in circumstances in which cause of death attribution is inadequate, a new category has been introduced: Pregnancy-related death is defined as the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the cause of death. From an epidemiological perspective, maternal death is a relatively rare event and mortality is difficult to measure accurately. Many low-income countries have no or very little data and modelling is used to obtain a national estimate.

The reduction of maternal deaths is a key international development goal. Public health policies and programs aiming to reduce maternal deaths need reliable and valid information, effective methods and tools for monitoring its progress, and evaluate interventions.

A tool is proposed for monitoring the number of maternal deaths and key causes of deaths that contribute to maternal mortality in the world and countries. Estimates of maternal deaths from the Global Burden of Diseases Study 2013 (GBD2013) was used as data source for this visualization. 

Key findings

  • In 2013 a total of 292,402 maternal deaths ocurred in the World, an important progress compared with 1980 where ocurred 385,312 maternal deaths. The most significant decreased was observed from 2004 to 2013.
  • The progress on maternal mortality varied across countries.
  • Hemorrhage, complications of abortion, other direct obstetric causes, and late maternal deaths are the top four leading causes of maternal mortality worldwide
  • Causes of death varied by regions and countries from 1980 to 2013. We encourage readers to interact with the visualization for exploring causes of deaths by countries. 
  • Young woman from age groups 20-24, 25-29 and 30-34 contributed with higher number of maternal deaths at global level
  • Hemorrhage, a preventable cause of maternal deaths, is one of the top cause of maternal mortality. 
  • Except for indirect causes,other direct obstetric causes, and late maternal deaths, the absolute number of deaths due to every causes decreased from 1980 to 2013
  • The two most important causes of maternal death in high-income countries in 2013 were indirect and other direct causes
  • The most important causes in low-income countries are other direct, abortion, and haemorrhage, which have not changed between 1990 and 2013.     

Public health implications

The majority of these maternal deaths could be avoided by expanding access to timely and quality care and addressing economic, geographic and cultural barriers. Births taking place in health care institutions, and at least four prenatal checkups for all pregnant women are minimum recommendations by World Health Organization. Among adolescents and young women aged 15 to 24 years, complications related to pregnancy, childbirth and immediately following birth remain among the top four causes of death.

Data source

Global Burden of Disease Study 2013. Global Burden of Disease Study 2013 (GBD 2013) Maternal Mortality Levels and Causes 1990-2013. Seattle, United States: Institute for Health Metrics and Evaluation (IHME), 2014. Available online (accessed May 28, 2016)

Reference

Nicholas J Kassebaunm, et al. Global, regional, and national levels and causes of maternal mortality during 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013. The Lancet, Volume 384, No. 9947, p980–1004, 13 September 2014. Available online (accessed May 28, 2016)

Related Contents

Trends in Maternal Mortality: selected countries from 1980 to 2013

This visualization allows comparing the level and trends in maternal mortality ratio from two selected countries.

Comments

Jamie Carson's picture

Hello Ramon - Great work, as always. A few comments - the age ranges appear to have a typo for the 40s. Also, the pop-up text says "In 2013, there *is* x ..." when it should say *were*. The age groups chart might also benefit from doing an standardized deaths per 100k in age group version: This might reveal changes such as delayed childbirth over time, as well as changes in relative risk by age group.
'Hope this is coherent and helpful to you! All the best, Jamie

martiner's picture

Hello Jamie,

Thanks you so much for the suggestions. I have corrected the typos on age group labels and tooltips. 

In this viz,I wanted to show causes of maternal deaths over time using absolute numbers and proportions. I'm working on a complementary data visualization showing maternal mortality ratio and eventually a simple analysis of annual change of rates.

I appreciate your comments, suggestions and enjoy the conversation on Twitter.

Best, 
Ramon

Muguwa Joseph's picture

Hello Ramon,

My appreciation for your article. Not away from the solid facts. Probably should have indicated that those low range age brackets are mainly from the low-income countries, with relatively low literacy rates, forceful marital obligations/underage marriages. Besides, the lack of the much needed competent/qualified nurses and birth attendants, migration, low-priority settings by governments, and other issues.

Nevertheless, Well done Ramon.

Ardi Kaptiningsih's picture

Hello Ramon,
Really appreciate your work. Very useful for the programme managers at national level. Thank you very much. There is also an updated information in the World Health Statistics 2016 for many health programmes, including maternal/reproductive and child health, which can be downloaded from www.who.int

Nkemdilim Nwodo's picture

I have to commend the effort that it took to collect this data and the efficacy and excellence by which it was executed. I just wanted to add that some of the decline that is indicated above might also be due to a more streamlined reporting protocol that has been put into place this past decade. Great Job

Gift Tamonde Mkhala's picture

This is really a job well done. One can clearly depict the importance of data collection as well as its use at the point of collection. I do hope epidemiology and biostatistics really plays a great role. What is needed is now to make evidence based decision making rather than thinking from the blues. Congrats.

Munir Ahmed's picture

This is a fantastic work done for the people who works and think for improvement of maternal health. However I find we are to think about other causes of maternal death which is very prominent in the developing countries - violence against women. Because of root causes like poverty and educational backwardness and male dominance this issue has been ignored and treated as part of culture. maternal death due to violence could be tracked if trend is being visualized. Otherwise, excellent work and educative......Munir

Munir Ahmed's picture

Great job done! I wonder if there is a room to accommodate the cause of maternal death due to violence which is predominantly an issue which is being ignored. The male dominant society always shape this type of causes as cultural issue and ignores and in developing countries people think this is natural and no need to worry about. If this is taken as a significant barrier to reduce maternal mortality and improve maternal health specifically young mothers the trend analysis would have been much more stronger. The work deserve great appreciation anyway.... Munir

Manmeet Kaur's picture

Very good visualizations Sir. I think one may also look into the survivals; even having the same cause some survived and other died. During the same period can we look into the survival pathways?

Rachel's picture

Thanks for this data. Does abortion mean spontaneous, elective, or anything else? This word is used differently in the medical field so some clarification would be helpful.

Catherine Chibal's picture

Thank you for this very good article. I did a study for my BSc. in the 90s in Zambia and the findings are much the same, avoidable causes of Maternal deaths such as hemorrhage and sepsis were high on my list of findings.

As long as lack of access to health services and unsafe abortions continue to take place in these countries; the trend will not change. Something needs to be done to ensure that abortion care is made available to those who need it and ante natal care (ANC) is made more accessible to all.

Mayira Sojo Milano's picture

Dear Ramon, I liked your job very much. This is a topic that must be faced as many times as possible. The data that you show is the reference to make better considerations about mother and child health programmes, health services and systems, as well as, of course, on structural determinants of health. I link the results you kindly share with us with human security in health.Thanks!

Muhiuddin Haider's picture

Very useful information related to maternal mortality. Can we compile information on interventions that reduce this mortality ? We can summarize this information based on MDG Reports, Case studies and DHS profiles. Out of all interventions, how many of them are associated with Behavior Change. Should we review BCC models along with Demographic and Epidemiological data? Just a thought to consider. Thanks

Mike Zdeb's picture

The maternal mortality rate in the US is most likely higher that reported in government statistics. It only reflects those deaths to women where a cause of death such as an embolism can be attributed to pregnancy due to some mention of pregnancy on the death certificate. That is not always the case. In work we did in the 1980s and 1990s in New York state, we found women who died of embolisms, hemorrhages, etc. on the day they delivered a baby yet the deaths were not coded as maternal deaths given that absence of any pregnancy information on the death certificate. I suspect that this still goes on today. See ...

http://www.popline.org/node/357966

http://docplayer.net/16908602-No-125-april-2001-enhanced-surveillance-of...

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