Temporal Evolution of Maternal Mortality: 1980-2019

Abstract Objective To determine the profile of maternal deaths occurred in the period between 2000 and 2019 in the Hospital de Clínicas de Porto Alegre (HCPA, in the Portuguese acronym) and to compare it with maternal deaths between 1980 and 1999 in the same institution. Methods Retrospective study that analyzed 2,481 medical records of women between 10 and 49 years old who died between 2000 and 2018. The present study was approved by the Ethics Committee (CAAE 78021417600005327). Results After reviewing 2,481 medical records of women who died in reproductive age, 43 deaths had occurred during pregnancy or in the postpartum period. Of these, 28 were considered maternal deaths. The maternal mortality ratio was 37.6 per 100,000 live births. Regarding causes, 16 deaths (57.1%) were directly associated with pregnancy, 10 (35.1%) were indirectly associated, and 2 (7.1%) were unrelated. The main cause of death was hypertension during pregnancy (31.2%) followed by acute liver steatosis during pregnancy (25%). In the previous study, published in 2003 in the same institution4, the mortality rate was 129 per 100,000 live births, and most deaths were related to direct obstetric causes (62%). The main causes of death in this period were due to hypertensive complications (17.2%), followed by postcesarean infection (16%). Conclusion Compared with data before the decade of 2000, there was an important reduction in maternal deaths due to infectious causes.摘要 目的：明确阿雷格里港临床医院（Hospital de Clínicas de Porto Alegre，缩写HCPA）2000年至2019年间发生的孕产妇死亡病例特征，并与该机构1980年至1999年的孕产妇死亡病例开展对比分析。 方法：本研究为回顾性研究，分析了2000年至2018年间死亡的10~49岁女性的2481份病历。本研究已通过伦理委员会审批（审查编号：CAAE 78021417600005327）。 结果：经复核2481份育龄死亡女性的病历，其中43例死亡发生于妊娠期或产后。在该43例中，28例被判定为孕产妇死亡。本次研究的孕产妇死亡比率为每10万活产37.6例。按病因分类，16例（57.1%）与妊娠直接相关，10例（35.1%）与妊娠间接相关，2例（7.1%）与妊娠无关联。主要死亡病因依次为妊娠期高血压疾病（31.2%），其次为妊娠期急性肝脂肪变性（25.0%）。在2003年发表于本机构的既往同类研究[4]中，孕产妇死亡比率为每10万活产129例，其中多数死亡病例与产科直接病因相关（62%）；该时期的主要死亡病因为高血压并发症（17.2%），其次为剖宫产后感染（16%）。 结论：与2000年以前的研究数据相比，本研究中感染性病因导致的孕产妇死亡占比出现了显著下降。