Institutional maternal and perinatal deaths: a review of 40 low- and middle-income countries
BMC Pregnancy and Childbirth, 2017
This paper uses secondary data from 40 low- and middle-income countries that conducted emergency obstetric and newborn care assessments over the last 10 years, and reviews 6.5 million deliveries, surveyed in 15,411 facilities.
Hemorrhage and hypertensive diseases contributed to one-third of institutional maternal deaths and indirect causes contributed another one-third (given the overrepresentation of sub-Saharan African countries with large proportions of indirect causes). The most lethal obstetric complication, across all regions, was ruptured uterus, followed by sepsis in Latin America and the Caribbean and sub-Saharan Africa. Stillbirth rates exceeded pre-discharge neonatal death rates in nearly all countries, possibly because women and their newborns were discharged soon after birth.