Maternal and perinatal mortality in the 21st century

Abstract

The maternal mortality ratio measures how safe it is to become pregnant and give birth in a geographic area or a population. The total number of maternal deaths observed annually fell from 526,000 in 1980 to 358,000 in 2008, a 34% decline over this period. Similarly, the global MMR declined from 422 in 1980 to 320 in 1990 and was 250 per 100,000 live births in 2008, a decline of 34% over the entire period and an average annual decline of 2.3%. More specifically, in 1990 around 58% of maternal deaths worldwide occurred in Asia and 36% in sub-Saharan Africa. In contrast, in 2008, 57% of global maternal deaths occurred in sub-Saharan Africa and 39% in Asia. In Europe, the main causes of death from any known direct obstetric complication remains bleeding (13%), thromboembolic events (10.1%), complicationassociated birth, hypertensive disease of pregnancy (9.2%), and amniotic fluid embolism (10.6%). Preterm birth is the most common cause of perinatal mortality (PNM) causing almost 30% of neonatal deaths, while birth defects cause about 21% of neonatal deaths. The PNM rate refers to the number of perinatal deaths per 1,000 total births. Perinatal mortality rate may be below 10 for certain developed countries and more than 10 times higher in developing countries. Perinatal health in Europe has improved dramatically in recent decades. In 1975, neonatal mortality ranged from 7 to 27 per 1,000 live births in the countries that now make up the EU. By 2005, it had declined to 8 per 1,000 live births. We need to bring together data from civil registration, medical birth registers, hospital discharge systems in order to have European Surveys which present exciting research possibilities.