Maternal Mortality Determinants in Refferal Hospital : Three Years Retrospective Study

Abstract

Maternal mortality rate is an indicator to assess women health status. Based on WHO data, the pregnancy and postpartum related complications mostly cause maternal mortality and predominantly occur in developing countries.The purpose of this research is to determine the causes of maternal deaths at H. Adam Malik General Hospital Medan based on maternal mortality risk factors including remote, intermediate, and outcome determinants. A retrospective study using medical records of women who underwent delivery at H. Adam Malik General Hospital, Medan from January 1st, 2010 until December 31th, 2012. Data were analyzed using bivariate and multivariate logistic regression. We analyzed complete medical records and found 37 maternal deaths during 3 years. Pre-eclampsia/eclampsia is the most common cause of death (20% and 37, 54.1%, respectively). Maternal education degree, referral system, facilities for delivery, history of systemic diseases, pregnancy and postpartum related complications were significantly correlated to the outcome of labor with OR =1.97, OR = 10.11, OR = 41.36, OR = 5.82, OR = 3.49 and OR = 685.7, respectively, p <0.05. Based on the multiple logistic regression test, maternal history of systemic diseases, pregnancy and postpartum related complications were the three factors that most significantly correlated to maternal mortality. Delivery outcomes were significantly associated with the following factors: formal education, referral status, facilities for delivery, history of systemic diseases, mode of delivery, pregnancy and postpartum related complications. Maternal history of systemic diseases, pregnancy and postpartum related complications were the three factors that most significantly correlated to maternal mortality.