Abstract
Background
Despite considerable efforts to reduce the maternal mortality ratio, numerous pregnant women continue to die in many developing countries, including Nigeria. We conducted a study to determine the incidence and causes of maternal mortality over an 8-month period in a rural-based secondary health facility located in Jahun, northern Nigeria.
Methods
A retrospective observational study was performed in a 41-bed obstetric ward. From October 2010 to May 2011, demographic data, obstetric characteristics, and outcome were collected from all pregnant women admitted. The total number of live births during the study period was recorded in order to calculate the maternal mortality ratio.
Results
There were 2,177 deliveries and 39 maternal deaths during the study period, with a maternal mortality ratio of 1,791/100,000 live births. The most common causes of maternal mortality were hemorrhage (26%), puerperal sepsis (19%), and obstructed labor (5%). No significant difference (P = 0.07) in mean time to reach the hospital was noted between fatal cases (1.9 hours, 95% confidence interval [CI] 1.1–2.6) and nonfatal cases (1.4 hours, 95% CI 1.4–1.5). Two hundred and sixty-six women were admitted presenting with stillbirth. Maternal mortality was higher for unbooked patients than for booked patients (odds ratio 5.1, 95% CI 3.5–6.2, P < 0.0001). The neonatal mortality rate was calculated at 46/1,000 live births. The main primary causes of neonatal deaths were prematurity (44%) and birth asphyxia (22%).
Conclusion
Maternal and neonatal mortality remains unacceptably high in this setting. Reducing unbooked emergencies should be a priority with continuous programs including orthodox practices in order to meet the fifth Millennium Development Goal.
Acknowledgments
We greatly acknowledge the Médecins Sans Frontières staff and all the dedicated Nigerian field workers and translators who assisted with this project.
Disclosure
The authors declare that they have no competing interests in this work.
Author contributions
GG, BO, and RG designed the study, and BO undertook the data collection. Analysis and interpretation was done by GG, BO, and MK. GG and MK drafted the manuscript, which was critically revised by BO and RG. All authors gave their final approval for publication of the manuscript.