Maternal Mortality: A Review of Aetiology in a Lassa Fever Endemic Region of Nigeria
DOI:
https://doi.org/10.31907/2309-4400.2020.08.07Keywords:
Maternal mortality, ISTH irrua, Obstetrics haemorrhage and eclampsia and lassa feverAbstract
Background: Maternal deaths are a subset of all female deaths; they are defined as any deaths that occur during pregnancy or childbirth or within 42 days after the birth or termination of a pregnancy. The Nigeria National Demographic Health Survey of 2018 (NDHS) reported that the lifetime risk of maternal death was 0.029, which indicated at the time of this report that 1,000 women (one in 34 women) would die before the age of 50 during pregnancy, during childbirth, or within 2 months of childbirth. Maternal mortality reduction is one of the key goals of the safe motherhood initiative which Nigeria endorsed and also one of the UN millennium development goals. Reducing maternal mortality in Nigeria has been a topical issue, efforts have been futile, and the scourge of maternal deaths have defiled many interventional attempts. In this study, a survey of pregnant women and hospital births in Irrua, South-South Nigeria was undertaken to examine factors associated with the trend of maternal mortality during or up to 42 days after pregnancy.
Objective: To determine the trends in maternal mortality in ISTH, identify the background, socio- cultural factors and major causes of maternal death.
Matherials and Methods: This was a retrospective cross sectional study of all pregnancy related deaths between January 2008 and December 2018. Case folders with complete information of interest where retrieved and relevant data obtained for analysis.
Results: The maternal mortality ratio (MMR) for the period under review was 531 per 100,000 live births. There were annual fluctuations in MMR with the highest ratio of 708 per 100,000 live births recorded in the year 2011. Obstetric Haemorrhage, Eclampsia and viral haemorrhagic fever (lassa fever) contributed 28%, 18% and 16% respectively to maternal mortality respectively. Teenagers and advanced maternal age, illiteracy and non-utilization of the services of skilled birth attendants were risk factors for maternal death.
Conclusion: This study reported high mortality ratio, but a downward trend from the last review in 2007. Obstetrics haemorrhage, eclampsia, and viral haemorrhagic fever (Lassa fever) were the highest contributors to maternal mortality in this study.Teenagers and advanced maternal age, illiteracy and non-utilisation of the services of a skilled birth attendant were risk factors for maternal death
References
National Population Commission (NPC) [Nigeria] and ICF. 2019. Nigeria Demographic and Health Survey 2018.
Abuja, Nigeria, and Rockville, Maryland, USA: NPC and ICF.Allan Rosenfeild, Deborah Maine; Maternal Mortality- A neglected tragedy. Where is the ”M” in MCH ? The Lancet volume 326, issue 8486,July 13,P83-85. https://doi.org/10.1016/s0140-6736(85)90188-6
Harrison K.A. Childbearing, Health, and Social Priorities: A survey of 22774 consecutive hospital births in Zaria, northern Nigeria, BJOG, 1985.
WHO; UNICEF; World Bank and United Nations Population Fund. Nigeria fights maternal mortality through improved quality of care. Abuja, 20 June 2018.
United Nations (UN), world health organization (WHO) and World Bank partner to combat maternal mortality. The World Bank group news release no. 2000/080/S.
Adamu Y. M., Salihu H. M., Sathiakumar N., Alexander G. R Maternal mortality in northern Nigeria: a population-based study. Eur. J. Obstet. Gynaecol. Reprod. Biol. 2003; 109: 153– 159. https://doi.org/10.1016/s0301-2115(03)00009-5
Gilda S., Henshaw S., Susheela S. et al. Induced abortion: Estimated rates and trends worldwide. Lancet. 2007; 370 (9595): 1338–1345. https://doi.org/10.1016/s0140-6736(07)61575-x
National Demographic and Health Survey, National Population Commission, Abuja, Nigeria; 2004 edition.
Yusuf M. A. Pattern of maternal morbidity and mortality in Kano State: A geographical analysis. J Soc Mgt Science. 9 (special edition) 2005, 196–221.
B.O Okusanya. Socio Demographic characteristic of maternal deaths in Irrua Nigeria. Niger J Med. 2007.
Mairiga A. G. and Saleh W. Maternal Mortality at the State Specialist Hospital Bauchi, northern Nigeria. East African Medical Journal. 2009; 86(1): 25–30. https://doi.org/10.4314/eamj.v86i1.46924
Ujah L. A. O., Aisien O. A., Mutihir J. T., Vander jag D. J., Glew R. H. and Uguru V. E. Factors contributing to maternal mortality in Jos, north-central Nigeria: A seventeen-year review. Afr J Reprod Health 2005, 9(3): 27–40. https://doi.org/10.2307/3583409
Agboghoroma O. C. and Emuveyan E. E. Maternal Mortality in Lagos, Nigeria: a ten-year review (1986-1995). Nig Quart J Hosp Med. 1997; 7: 230–233.
Olatunji A. O. and Sule-Odu. Maternal Mortality at Sagamu, Nigeria. A ten-year review (1988-1997); The Nig. Postgr. Med. J. 2001; 8(1): 12–18. https://doi.org/10.4314/nmp.v58i4.66769
Lale S. Mie I. Samuel M and Emi S. Mortality in 2005: estimates developed by WHO, UNICEF, UNFPA and the World Bank. Geneva: WHO; 2007; 15–17.
B.M Audu, U.I. Takai, M Bukar. The trends in maternal mortality at UMTH, Mmiduguri Nigeria, A five year review. Nigeria Medical journal Oct 2010.
