Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
BMC Pregnancy and Childbirth
Published in: BMC Pregnancy and Childbirth 1/2017

Open Access 01-12-2017 | Research article

Maternal mortality audit in Suriname between 2010 and 2014, a reproductive age mortality survey

Authors: Lachmi R. Kodan, Kim J. C. Verschueren, Jos van Roosmalen, Humphrey H. H. Kanhai, Kitty W. M. Bloemenkamp

Published in: BMC Pregnancy and Childbirth | Issue 1/2017

Login to get access

Abstract

Background

The fifth Millennium Development Goal (MDG-5) aimed to improve maternal health, targeting a maternal mortality ratio (MMR) reduction of 75% between 1990 and 2015. The objective of this study was to identify all maternal deaths in Suriname, determine the extent of underreporting, estimate the reduction, audit the maternal deaths and assess underlying causes and substandard care factors.

Methods

A reproductive age mortality survey was conducted in Suriname (South-American upper-middle income country) between 2010 and 2014 to identify all maternal deaths in the country. MMR was compared to vital statistics and a previous confidential enquiry from 1991 to 1993 with a MMR 226. A maternal mortality committee audited the maternal deaths and identified underlying causes and substandard care factors.

Results

In the study period 65 maternal deaths were identified in 50,051 live births, indicating a MMR of 130 per 100.000 live births and implicating a 42% reduction of maternal deaths in the past 25 years. Vital registration indicated a MMR of 96, which marks underreporting of 26%. Maternal deaths mostly occurred in the urban hospitals (84%) and the causes were classified as direct (63%), indirect (32%) or unspecified (5%). Major underlying causes were obstetric and non-obstetric sepsis (27%) and haemorrhage (20%). Substandard care factors (95%) were mostly health professional related (80%) due to delay in diagnosis (59%), delay or wrong treatment (78%) or inadequate monitoring (59%). Substandard care factors most likely led to death in 47% of the cases.

Conclusion

Despite the reduction in maternal mortality, Suriname did not reach MDG-5 in 2015. Steps to reach the Sustainable Development Goal in 2030 (MMR ≤ 70 per 100.000 live births) and eliminate preventable deaths include improving data surveillance, installing a maternal death review committee, and implementing national guidelines for prevention and management of major complications of pregnancy, childbirth and puerperium.
Literature
1.
GBD 2015 Maternal Mortality Collaborators. Global, regional, and national levels of maternal mortality, 1990–2015: a systematic analysis for the global burden of disease study 2015. Lancet. 2016;388(10053):1775–812. doi:10.​1016/​S0140-6736(16)31470-2.
2.
Alkema L, Chou D, Hogan D, Zhang S, Moller A, Gemmill A, et al. Global, regional, and national levels and trends in maternal mortality between 1990 and 2015, with scenario-based projections to 2030: a systematic analysis by the UN maternal mortality estimation inter-agency group. Lancet. 2016;387(10017):462–74.CrossRefPubMed
3.
Say L, Chou D, Gemmill A, Tuncalp Ö, Moller A, Daniels J, et al. Global causes of maternal death: a WHO systematic analysis. Lancet Glob Health. 2014;2(6):e323–33.CrossRefPubMed
4.
Mungra A, van Kanten R, Kanhai H, van Roosmalen J. Nationwide maternal mortality in Surinam. BJOG. 1999;106(1):55–9.CrossRef
5.
Mungra A, van Bokhoven S, Florie J, van Kanten R, van Roosmalen J, Kanhai H. Reproductive age mortality survey to study under-reporting of maternal mortality in Surinam. Eur J Obstet Gynaecol Reprod Biol. 1998;77(1):37–9.CrossRef
6.
7.
8.
9.
10.
General Bureau of Statistics – Suriname. Statistical Yearbook 2013. Suriname in numbers no. 310-2014/11. 2014. Accessed 15 May 2015.
11.
The WHO Application of ICD-10 to Deaths During Pregnancy, Childbirth and the Puerperium: ICD-MM. World Health Organization, Geneva. 2013. Accessed 10 Apr 2015.
12.
13.
Punwasi W. Causes of death in Suriname 2010-2011. Report Bureau Openbare Gezondheidsdienst. Published 2012. Accessed 2 Apr 2015.
14.
15.
De Brouwere V, Zinnen V, Delvaux T, Leke R. Guidelines and tools for organizing and conducting maternal death reviews. Int J Gynaecol Obstet. 2014;127:S21–3.CrossRefPubMed
16.
McCaw-Binns A, Lindo J, Lewis-Bell K, Ashley D. Maternal mortality surveillance in Jamaica. Int J Gynaecol Obstet. 2008;100(1):31–6.CrossRefPubMed
17.
Ramos S, Karolinski A, Romero M, Mercer R. A comprehensive assessment of maternal deaths in Argentina: translating multicentre collaborative research into action. Bull World Health Organ. 2007;85(8):615–22.CrossRefPubMedPubMedCentral
18.
Hogan MC, Saavedra-Avendano B, Darney BG, et al. Reclassifying causes of obstetric death in Mexico: a repeated cross-sectional study. Bull World Health Organ. 2016;94(5):362–369B. doi:10.​2471/​BLT.​15.​163360
19.
20.
Horon I. Underreporting of maternal deaths on death certificates and the magnitude of the problem of maternal mortality. Am J Public Health. 2005;95(3):478–82.CrossRefPubMedPubMedCentral
21.
Horon IL, Cheng D. Effectiveness of pregnancy check boxes on death certificates in identifying pregnancy-associated mortality. Public Health Rep. 2011;126(2):195–200.CrossRefPubMedPubMedCentral
22.
Mgawadere F, Unkels R, van den Broek N. Assigning cause of maternal death: a comparison of findings by a facility-based review team, an expert panel using the new ICD-MM cause classification and a computer-based program (InterVA-4). BJOG. 2016;123(10):1647–53. doi:10.​1111/​1471-0528.​13969.
23.
Alam N, Hobbelink EL, van Tienhoven AJ, van de Ven PM, Jansma EP, Nanayakkara PWB. The impact of the use of the early warning score (EWS) on patient outcomes: a systematic review. Resuscitation. 2014;85(5):587–94.CrossRefPubMed
Metadata
Title
Maternal mortality audit in Suriname between 2010 and 2014, a reproductive age mortality survey
Authors
Lachmi R. Kodan
Kim J. C. Verschueren
Jos van Roosmalen
Humphrey H. H. Kanhai
Kitty W. M. Bloemenkamp
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Pregnancy and Childbirth / Issue 1/2017
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/s12884-017-1466-6

Other articles of this Issue 1/2017

BMC Pregnancy and Childbirth 1/2017 Go to the issue

Research article

High sero-prevalence of hepatitis B virus and human immunodeficiency virus infections among pregnant women attending antenatal clinic at Temeke municipal health facilities, Dar es Salaam, Tanzania: a cross sectional study

Research article

Use of Rapid Ascertainment Process for Institutional Deaths (RAPID) to identify pregnancy-related deaths in tertiary-care obstetric hospitals in three departments in Haiti

Research article

Stillbirth is associated with perceived alterations in fetal activity – findings from an international case control study

Research article

Trial of labour or elective repeat caesarean delivery:are women making an informed decision at Kenyatta national hospital?

Research article

Experiences and wishes of women regarding systemic aspects of midwifery care in Germany: a qualitative study with focus groups

Research article

Companion of choice at birth: factors affecting implementation