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Created on : 09 Apr 2006
Modified on : 14 Jan 2018

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Bibliographical entry (without author) :

Maternal mortality as an indicator of obstetric care in Europe. BJOG, 111(2):164-9.

Author(s) :

Wildman K, Bouvier-Colle MH; MOMS Group.

Year of publication :

2004

URL(s) :

https://www.ncbi.nlm.nih.gov/pubmed/14723755

Résumé (français)  :

Abstract (English)  :

OBJECTIVE: This analysis considers the usefulness of maternal mortality ratio (MMR) as an indicator of obstetric care in the context of low overall maternal mortality. We explore whether variation in the level of MMR among European countries reflects differences in obstetric care.

DESIGN: The data presented in this article were collected as part of the European Concerted Action on Mothers’ Mortality and Severe morbidity (MOMS). In this study, a panel of experts followed a protocol to determine cause of death and whether it was pregnancy-related. This analysis uses the expert panel’s confirmation of cause of death and obstetric attribution.

SETTING: All maternal deaths within 11 European countries.

POPULATION: Two hundred and ninety obstetric deaths occuring between 1992 and 1995.

METHODS: We present the results of a multivariable analysis that controls for cause of death, moment of death, place of death, pregnancy outcome, women’s age and nationality.

MAIN OUTCOME MEASURES: We test the hypothesis that countries with higher MMR would have proportionally more cases of direct obstetric death due to thromboembolism, hypertension, haemorrhage or infection compared with other countries in the study. We examine timing of death and maternal age to measure whether there are differences between country groups for older mothers.

RESULTS: We find distinct patterns in cause and timing of death and age-specific mortality ratios between countries with different levels of MMR.

CONCLUSIONS: Despite low rates of maternal mortality in Europe, between-country differences follow patterns with respect to cause and timing of death and maternal age. In addition to representing an important indicator of health status in a country, differences in MMR among European countries provide insight to where obstetric care plays a role maternal deaths.

Sumário (português)  :

Resumen (español)  :

Comments :

Argument (français) :

En dépit des faibles taux de mortalité en Europe, les différences entre les pays traduisent la qualité des soins apportés via leur cause, le moment de la mort et l’age maternel.

Argument (English):

Argumento (português):

Argumento (español):

Keywords :

➡ evidence-based medicine/midwifery ; public health ; maternal age ; morbidity ; maternal death rate ; perinatal death rates

Author of this record :

Bernard Bel — 09 Apr 2006
➡ latest update : Alison Passieux — 14 Jan 2018