Evaluation of Frequency & Sociodemographic Determinants of Maternal Mortality and Maternal Near Miss Events in a Rural Tertiary Care Institute of India

Abstract

Aim and Background: The health of mothers is crucial because it determines the position of women in society. Bringing the maternal mortality rate down to below 70 per 100,000 live births by 2030 is one way to achieve the UN Sustainable Development Goals of improving maternal health. [1] Material and Method: A rural Indian tertiary care hospital conducted prospective observational research for two years. The Ministry of Health and Family Welfare (HFW) of the Government of India's Maternal Near Miss (MNM) Study Operational Procedures Dec 2014 (Annexure I) were used to categorise MNM cases. The study covered all occurrences of maternal death that occurred throughout the time frame. MMR, Case Fatality Rate, MNMIR, MNM:MM Ratio, Mortality index were observed. Socio-Demographic corelations of MNM and MM cases with age, parity, occupation, socioeconomic status, literacy and distribution in rural and urban population were analysed in this study. Results: During the period of study 8508 deliveries, 8,240 live births (LB), 125 MNMs and 29 MMs were recorded. MNMIR was 15.1/1000LB, MNM:MM ratio 4.3:1 and MM index 18.8%. Leading cause of MNM was haemorrhage(36%) and MM was medical disorders(34.4%).MNM (80.8%) and MM(75.9%) were more amongst the age of 20-29 yrs. Both MNM and MM were significantly more in multigravida (57.6% & 58.6% respectively). Significantly more MNM (62.4%) and MM (75.9%) cases were housewives than working women and more MNM and MM cases were educated less than 5th std. (MNM - 64% and MM -58.6%) In socioeconomic status significantly more MNM (80.8%) and MM (89.7%) cases were women below poverty line and from rural population [MNM (72%) and MM (89%)]. Conclusions: While bleeding was more common, infectious and medical conditions had higher case fatality rates. Housewives, women from low-income backgrounds, those living in rural areas, and women without a high school diploma were found to have a much higher risk of having a worse maternal healthiness result.