Causes of maternal mortality and the effectiveness of healthcare services: a retrospective analysis in Adana province
DOI:
https://doi.org/10.37609/srinmed.69Keywords:
Maternal death, Mortality, Refugee, Health Care, Pregnancy, Public HealthAbstract
Objective: This study aims to retrospectively analyze maternal deaths occurring in Adana province between 2011 and 2016, evaluating the causes of death, demographic and clinical characteristics, and access to healthcare services.
Method: A total of 105 maternal death cases were analyzed. The majority of the cases were married, had low education levels, and were covered by the Social Security Institution or the “Green Card” system. Syrian refugees accounted for 9.5% of maternal deaths, with partial differences observed in their access to healthcare services.
Result: The majority of maternal deaths resulted from direct (34.3%) and indirect (50.5%) causes. It was determined that the number of consultations with an obstetrician was higher in direct maternal deaths and lower in coincidental deaths. The cesarean section rate was high (72.4%), and deaths predominantly occurred during the postpartum period (72.4%). Most deaths took place in tertiary healthcare institutions, with an increase in mortality rates observed during shift hours.
Conclusion: To reduce maternal mortality, it is recommended to strengthen primary healthcare services, control cesarean section rates, and develop more inclusive health policies for refugees. This study provides significant data for determining policies to prevent maternal mortality and increasing the effectiveness of healthcare services.
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References
Dol J, Hughes B, Bonet M, Dorey R, Dorling J, Grant A, et al. Timing of maternal mortality and severe morbidity during the postpartum period: a systematic review. JBI Evid Synth. 2022;20 (9):2119-94.
Victora CG, Requejo JH, Barros AJ, Berman P, Bhutta Z, Boerma T, et al. Countdown to 2015: a decade of tracking progress for maternal, newborn, and child survival. Lancet. 2016;387 (10032):2049-59.
Yıldırım AD, Şahin NH. Anne ölümlerinin önlenmesi: uluslararası bakım ve izlem modelleri. Jinekoloji-Obstetrik ve Neonatoloji Tıp Dergisi. 2022;19 (1):1184-91.
Say L, Chou D, Gemmill A, Tunçalp Ö, Moller AB, Daniels J, et al. Global causes of maternal death: a WHO systematic analysis. Lancet Glob Health. 2014;2 (6):e323-33.
Filippi V, Chou D, Ronsmans C, Graham W, Say L. Levels and Causes of Maternal Mortality and Morbidity. In: Black RE, Laxminarayan R, Temmerman M, Walker N, editors. Reproductive, Maternal, Newborn, and Child Health: Disease Control Priorities, Third Edition (Volume 2). Washington (DC): The International Bank for Reconstruction and Development / The World Bank© 2016 International Bank for Reconstruction and Development / The World Bank.; 2016.
Nurdoğan AK, Dur AİB, Öztürk M. Türkiye’nin mülteci sorunu ve Suriye krizinin mülteci sorununa etkileri. İş ve Hayat. 2016;2 (4):217-38.
Basha S, Socarras A, Akhter MW, Hamze M, Albaik A, Hussein I, et al. Protracted armed conflict and maternal health: a scoping review of literature and a retrospective analysis of primary data from northwest Syria. BMJ Glob Health. 2022;7 (8).
Smith LK, Hindori-Mohangoo AD, Delnord M, Durox M, Szamotulska K, Macfarlane A, et al. Quantifying the burden of stillbirths before 28 weeks of completed gestational age in high-income countries: a population-based study of 19 European countries. Lancet. 2018;392 (10158):1639-46.
Knight M, Bunch K, Vousden N, Banerjee A, Cox P, Cross-Sudworth F, et al. A national cohort study and confidential enquiry to investigate ethnic disparities in maternal mortality. EClinicalMedicine. 2022;43:101237.
Baeten JM, Bukusi EA, Lambe M. Pregnancy complications and outcomes among overweight and obese nulliparous women. Am J Public Health. 2001;91 (3):436-40.
Topaktaş G, Beylik U. Türkiye sezaryen orani durum analizi ve politika önerileri. Jinekoloji-Obstetrik ve Neonatoloji Tıp Dergisi. 2024;21 (2):102-13.
Kassebaum NJ, Bertozzi-Villa A, Coggeshall MS, Shackelford KA, Steiner C, Heuton KR, et al. Global, regional, and national levels and causes of maternal mortality during 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2014;384 (9947):980-1004.
McCaw-Binns AM, Campbell LV, Spence SS. The evolving contribution of non-communicable diseases to maternal mortality in Jamaica, 1998-2015: a population-based study. Bjog. 2018;125 (10):1254-61.
Merry L, Semenic S, Gyorkos TW, Fraser W, Gagnon AJ. Predictors of Unplanned Cesareans among Low-Risk Migrant Women from Low- and Middle-Income Countries Living in Montreal, Canada. Birth. 2016;43 (3):209-19.
Hogan MC, Foreman KJ, Naghavi M, Ahn SY, Wang M, Makela SM, et al. Maternal mortality for 181 countries, 1980-2008: a systematic analysis of progress towards Millennium Development Goal 5. Lancet. 2010;375 (9726):1609-23.
Lisonkova S, Potts J, Muraca GM, Razaz N, Sabr Y, Chan WS, et al. Maternal age and severe maternal morbidity: A population-based retrospective cohort study. PLoS Med. 2017;14 (5):e1002307.
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