Calidad de las estadísticas de mortalidad materna en Cuba, 2013

Abstract

Objective. Evaluate the degree of integrity of the Cuban statistical registry of maternal deaths and the quality of the classification of the causes of death included in that registry. Methods. We analyzed the information of all Cuban women who died in fertile age in 2013 according to the continuous mortality registry of the Directorate of Medical Records and Health Statistics of the Ministry of Public Health of Cuba (MINSAP), regardless of the main cause of death informed. Four research groups (national, expert, provincial and health units), each with defined functions, applied four forms to establish if the women had been pregnant in the year prior to death, to reassess whether the cases corresponded to a maternal death and, in that case, to review the classification. Results. Deaths of 2 731 women of reproductive age notified in Cuba in 2013 were assessed. Of them, the cause of death of 2 711 (99.3%) was conclusive and, of these, 97 (3.6%) had had a pregnancy in the year prior to death. We found 50 maternal deaths (one more than in the continuous registry) for a 2% error and an adjustment factor of 1.02. Of the 97 deaths studied, only 4 cases were reclassified: 2 maternal deaths and 1 death related to pregnancy, delivery and puerperium, according to the continuous registry, which were reclassified as direct deaths; and 1 death considered non-maternal by the continuous registry that was reclassified as late maternal death, for a 95.9% concordance. Conclusions. The information on maternal deaths included in the MINSAP’s continuous mortality registry has a high level of integrity. The quality of the classification of maternal deaths in this registry is high; reclassification of causes of death is uncommon.