Global causes of maternal death: a WHO systematic analysis

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Global causes of maternal death : a WHO systematic analysis. / Say, Lale; Chou, Doris; Gemmill, Alison; Tunçalp, Özge; Moller, Ann-Beth; Daniels, Jane; Gülmezoglu, A Metin; Temmerman, Marleen; Alkema, Leontine.

In: Lancet Global Health, Vol. 2, No. 6, 06.2014, p. e323-33.

Research output: Contribution to journalArticle

Harvard

Say, L, Chou, D, Gemmill, A, Tunçalp, Ö, Moller, A-B, Daniels, J, Gülmezoglu, AM, Temmerman, M & Alkema, L 2014, 'Global causes of maternal death: a WHO systematic analysis', Lancet Global Health, vol. 2, no. 6, pp. e323-33. https://doi.org/10.1016/S2214-109X(14)70227-X

APA

Say, L., Chou, D., Gemmill, A., Tunçalp, Ö., Moller, A-B., Daniels, J., Gülmezoglu, A. M., Temmerman, M., & Alkema, L. (2014). Global causes of maternal death: a WHO systematic analysis. Lancet Global Health, 2(6), e323-33. https://doi.org/10.1016/S2214-109X(14)70227-X

Vancouver

Author

Say, Lale ; Chou, Doris ; Gemmill, Alison ; Tunçalp, Özge ; Moller, Ann-Beth ; Daniels, Jane ; Gülmezoglu, A Metin ; Temmerman, Marleen ; Alkema, Leontine. / Global causes of maternal death : a WHO systematic analysis. In: Lancet Global Health. 2014 ; Vol. 2, No. 6. pp. e323-33.

Bibtex

@article{5bcc685e55b948b380fab169fc76a321,
title = "Global causes of maternal death: a WHO systematic analysis",
abstract = "BACKGROUND: Data for the causes of maternal deaths are needed to inform policies to improve maternal health. We developed and analysed global, regional, and subregional estimates of the causes of maternal death during 2003-09, with a novel method, updating the previous WHO systematic review.METHODS: We searched specialised and general bibliographic databases for articles published between between Jan 1, 2003, and Dec 31, 2012, for research data, with no language restrictions, and the WHO mortality database for vital registration data. On the basis of prespecified inclusion criteria, we analysed causes of maternal death from datasets. We aggregated country level estimates to report estimates of causes of death by Millennium Development Goal regions and worldwide, for main and subcauses of death categories with a Bayesian hierarchical model.FINDINGS: We identified 23 eligible studies (published 2003-12). We included 417 datasets from 115 countries comprising 60 799 deaths in the analysis. About 73% (1 771 000 of 2 443 000) of all maternal deaths between 2003 and 2009 were due to direct obstetric causes and deaths due to indirect causes accounted for 27·5% (672 000, 95% UI 19·7-37·5) of all deaths. Haemorrhage accounted for 27·1% (661 000, 19·9-36·2), hypertensive disorders 14·0% (343 000, 11·1-17·4), and sepsis 10·7% (261 000, 5·9-18·6) of maternal deaths. The rest of deaths were due to abortion (7·9% [193 000], 4·7-13·2), embolism (3·2% [78 000], 1·8-5·5), and all other direct causes of death (9·6% [235 000], 6·5-14·3). Regional estimates varied substantially.INTERPRETATION: Between 2003 and 2009, haemorrhage, hypertensive disorders, and sepsis were responsible for more than half of maternal deaths worldwide. More than a quarter of deaths were attributable to indirect causes. These analyses should inform the prioritisation of health policies, programmes, and funding to reduce maternal deaths at regional and global levels. Further efforts are needed to improve the availability and quality of data related to maternal mortality.",
keywords = "Cause of Death, Female, Global Health, Humans, Maternal Mortality, Pregnancy, Pregnancy Complications, World Health Organization",
author = "Lale Say and Doris Chou and Alison Gemmill and {\"O}zge Tun{\c c}alp and Ann-Beth Moller and Jane Daniels and G{\"u}lmezoglu, {A Metin} and Marleen Temmerman and Leontine Alkema",
note = "{\textcopyright} 2014 World Health Organization; licensee Elsevier. This is an Open Access article published without any waiver of WHO's privileges and immunities under international law, convention, or agreement. This article should not be reproduced for use in association with the promotion of commercial products, services, or any legal entity. There should be no suggestion that WHO endorses any specific organisation or products. The use of the WHO logo is not permitted. This notice should be preserved along with the article's original URL.",
year = "2014",
month = jun
doi = "10.1016/S2214-109X(14)70227-X",
language = "English",
volume = "2",
pages = "e323--33",
journal = "Lancet Global Health",
issn = "2214-109X",
publisher = "Elsevier",
number = "6",

}

RIS

TY - JOUR

T1 - Global causes of maternal death

T2 - a WHO systematic analysis

AU - Say, Lale

AU - Chou, Doris

AU - Gemmill, Alison

AU - Tunçalp, Özge

AU - Moller, Ann-Beth

AU - Daniels, Jane

AU - Gülmezoglu, A Metin

AU - Temmerman, Marleen

AU - Alkema, Leontine

N1 - © 2014 World Health Organization; licensee Elsevier. This is an Open Access article published without any waiver of WHO's privileges and immunities under international law, convention, or agreement. This article should not be reproduced for use in association with the promotion of commercial products, services, or any legal entity. There should be no suggestion that WHO endorses any specific organisation or products. The use of the WHO logo is not permitted. This notice should be preserved along with the article's original URL.

PY - 2014/6

Y1 - 2014/6

N2 - BACKGROUND: Data for the causes of maternal deaths are needed to inform policies to improve maternal health. We developed and analysed global, regional, and subregional estimates of the causes of maternal death during 2003-09, with a novel method, updating the previous WHO systematic review.METHODS: We searched specialised and general bibliographic databases for articles published between between Jan 1, 2003, and Dec 31, 2012, for research data, with no language restrictions, and the WHO mortality database for vital registration data. On the basis of prespecified inclusion criteria, we analysed causes of maternal death from datasets. We aggregated country level estimates to report estimates of causes of death by Millennium Development Goal regions and worldwide, for main and subcauses of death categories with a Bayesian hierarchical model.FINDINGS: We identified 23 eligible studies (published 2003-12). We included 417 datasets from 115 countries comprising 60 799 deaths in the analysis. About 73% (1 771 000 of 2 443 000) of all maternal deaths between 2003 and 2009 were due to direct obstetric causes and deaths due to indirect causes accounted for 27·5% (672 000, 95% UI 19·7-37·5) of all deaths. Haemorrhage accounted for 27·1% (661 000, 19·9-36·2), hypertensive disorders 14·0% (343 000, 11·1-17·4), and sepsis 10·7% (261 000, 5·9-18·6) of maternal deaths. The rest of deaths were due to abortion (7·9% [193 000], 4·7-13·2), embolism (3·2% [78 000], 1·8-5·5), and all other direct causes of death (9·6% [235 000], 6·5-14·3). Regional estimates varied substantially.INTERPRETATION: Between 2003 and 2009, haemorrhage, hypertensive disorders, and sepsis were responsible for more than half of maternal deaths worldwide. More than a quarter of deaths were attributable to indirect causes. These analyses should inform the prioritisation of health policies, programmes, and funding to reduce maternal deaths at regional and global levels. Further efforts are needed to improve the availability and quality of data related to maternal mortality.

AB - BACKGROUND: Data for the causes of maternal deaths are needed to inform policies to improve maternal health. We developed and analysed global, regional, and subregional estimates of the causes of maternal death during 2003-09, with a novel method, updating the previous WHO systematic review.METHODS: We searched specialised and general bibliographic databases for articles published between between Jan 1, 2003, and Dec 31, 2012, for research data, with no language restrictions, and the WHO mortality database for vital registration data. On the basis of prespecified inclusion criteria, we analysed causes of maternal death from datasets. We aggregated country level estimates to report estimates of causes of death by Millennium Development Goal regions and worldwide, for main and subcauses of death categories with a Bayesian hierarchical model.FINDINGS: We identified 23 eligible studies (published 2003-12). We included 417 datasets from 115 countries comprising 60 799 deaths in the analysis. About 73% (1 771 000 of 2 443 000) of all maternal deaths between 2003 and 2009 were due to direct obstetric causes and deaths due to indirect causes accounted for 27·5% (672 000, 95% UI 19·7-37·5) of all deaths. Haemorrhage accounted for 27·1% (661 000, 19·9-36·2), hypertensive disorders 14·0% (343 000, 11·1-17·4), and sepsis 10·7% (261 000, 5·9-18·6) of maternal deaths. The rest of deaths were due to abortion (7·9% [193 000], 4·7-13·2), embolism (3·2% [78 000], 1·8-5·5), and all other direct causes of death (9·6% [235 000], 6·5-14·3). Regional estimates varied substantially.INTERPRETATION: Between 2003 and 2009, haemorrhage, hypertensive disorders, and sepsis were responsible for more than half of maternal deaths worldwide. More than a quarter of deaths were attributable to indirect causes. These analyses should inform the prioritisation of health policies, programmes, and funding to reduce maternal deaths at regional and global levels. Further efforts are needed to improve the availability and quality of data related to maternal mortality.

KW - Cause of Death

KW - Female

KW - Global Health

KW - Humans

KW - Maternal Mortality

KW - Pregnancy

KW - Pregnancy Complications

KW - World Health Organization

U2 - 10.1016/S2214-109X(14)70227-X

DO - 10.1016/S2214-109X(14)70227-X

M3 - Article

C2 - 25103301

VL - 2

SP - e323-33

JO - Lancet Global Health

JF - Lancet Global Health

SN - 2214-109X

IS - 6

ER -