Belgian Audit system for Maternal Mortality

On very rare occasions a mother will die during pregnancy or childbirth in Belgium. We estimate about 12 women per year, based on current data of STATBEL and the Maternal Mortality Ratio (MMR) of our neighboring countries. At this point (december 2020) we know very little about these mothers. The information of their death is limited to the data on the death certificates, and in Flanders from what was communicated as the cause of death to the SPE (Vlaamse Studiecentrum voor Perinatale Epidemiologie).

This unlike our neighboring countries (the United Kingdom, the Netherlands, France, Italy) who have an enhanced maternal mortality registration and analysis system since years. The most known being the MBRRACE-UK, Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries across the UK.

Thanks to these systems we know that an important number of the deceased mothers had an underlying disease, for example a heart disease, which aggravated during pregnancy. And importantly, the in-depth analyses of maternal deaths in our neighboring countries revealed 'substandard care' in more than half of cases, which (may have) contributed to the death of these mothers.

Therefore, the Federal Public Service of Public Health strongly supports the Belgian Analysis system for Maternal Mortality that registers and analyses the cases of maternal death in Belgium, in a structured manner by a national multidisciplinary expert team.

在比利时，孕产妇在妊娠或分娩期间死亡的情况极为罕见。根据比利时统计署（STATBEL）的最新数据以及周边国家的孕产妇死亡率（Maternal Mortality Ratio, MMR），我们估算每年约有12名孕产妇因此离世。截至2020年12月，我们对这类孕产妇的相关信息所知甚少，其死亡相关资料仅局限于死亡证明数据；在佛兰德斯地区，相关信息还仅包含上报给SPE（佛兰德斯围产期流行病学研究中心，Vlaamse Studiecentrum voor Perinatale Epidemiologie）的死亡原因。

而比利时的周边国家（英国、荷兰、法国、意大利）多年来已建立起成熟的孕产妇死亡登记与分析体系，其中最为人熟知的当属MBRRACE-UK项目——《全英母婴：通过审核与保密调查降低风险》（Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries across the UK）。

借助这些完善的登记分析体系，我们得以了解到，大量离世孕产妇均患有基础疾病，例如心脏病，并在妊娠期间病情出现恶化。尤为关键的是，周边国家针对孕产妇死亡案例开展的深度分析显示，超半数案例存在“照护不达标”情况，该情况可能是导致孕产妇死亡的诱因之一。

因此，比利时联邦公共卫生服务部大力支持建立比利时孕产妇死亡分析体系，由国家多学科专家团队以结构化方式对比利时境内的孕产妇死亡案例进行登记与分析。