Autopsy-certified maternal mortality at Ile-Ife, Nigeria

Figures & data

Table 1 Distribution of the causes of maternal death by age

Category	Cause	Age group (years), n
		15–19	20–24	25–29	30–34	35–39	40–44	45–49	N (%)
Direct (obstetric) causes	Obstetric hemorrhage	1	2	9	4	7	3	0	26 (30.9)
	Complications of abortion	5	8	2	3	2	0	0	20 (23.8)
	Preeclampsia/eclampsia	2	1	3	0	1	0	0	7 (8.3)
	Complications of labor	1	0	1	3	1	0	1	7 (8.3)
Indirect (nonobstetric) causes	Nongenital infections	1	1	4	2	4	0	0	12 (14.2)
	Anemia	2	1	1	0	2	0	0	6 (7.1)
	Complications from preexisting hypertension	0	1	0	0	3	1	0	5 (5.9)
	Neoplasms	0	0	0	1	0	0	0	1 (1.2)
N (%)		12 (14.3)	14 (16.6)	20 (23.8)	13 (15.5)	20 (23.8)	4 (4.7)	1 (1.2)	84 (100.0)

Table 2 Distribution of the causes of maternal death by stage of pregnancy

Category	Cause	Stage of pregnancy, n
		T1	T2	T3	Delivery	Postpartum period	N (%)
Direct (obstetric) causes	Obstetric hemorrhage	0	4	4	1	17	26 (30.9)
	Complications of abortion	9	11	0	0	0	20 (23.8)
	Preeclampsia/eclampsia	0	0	3	1	3	7 (8.3)
	Complications of labor	0	0	0	4	3	7 (8.3)
Indirect (nonobstetric) causes	Nongenital infections	1	6	4	0	1	12 (14.2)
	Anemia	1	3	1	0	1	6 (7.1)
	Complications from preexisting hypertension	0	0	3	2	0	5 (5.9)
	Neoplasms	0	1	0	0	0	1 (1.2)
N (%)		11 (13.1)	25 (29.8)	15 (17.8)	8 (9.5)	25 (29.8)	84 (100.0)

Notes: A statistically significant relationship was found between the timing of pregnancy and direct causes of maternal death (P<0.001). The relationship between pregnancy and indirect causes of maternal death was not significant (P>0.05).

Abbreviations: T1, first trimester; T2, second trimester; T3, third trimester.

Figure 1 Parity in relation to the direct causes of maternal death.

Notes: Parity groups: 1, Nullipara (never given birth); 2, Para 1 (given birth one time); 3, Para 2–4 (given birth two, three, or four times); 4, >Para 4 (given birth more than four times). Obstetric hemorrhage and complications of labor were more common among Para 2–4 individuals, whereas the complications of abortion and preeclampsia/eclampsia were more common in the Nullipara group (P=0.009).
Abbreviations: AC, complications of abortion; CL, complications of labor; PE, preeclampsia/eclampsia; OH, obstetric hemorrhage.

Table 3 Specific causes of certain categories of maternal death

Category	Cause	N (%)
Antepartum hemorrhage (n=9)	Abruptio placentae	6 (66.7)
	Ruptured uterus	1 (11.1)
	Ruptured ectopic pregnancy	1 (11.1)
	Placenta previa	1 (11.1)
Postpartum hemorrhage (n=17)	Uterine atony	13 (76.4)
	Ruptured uterus	2 (11.8)
	Retained placenta	2 (11.8)
Complications of abortion (n=20)	Septicemia	11 (55.0)
	Hemorrhage	5 (25.0)
	Uterine perforation	4 (20.0)
Nongenital infections (n=12)	Purulent meningitis	5 (41.7)
	Pulmonary tuberculosis	3 (25.0)
	Pneumonia	3 (25.0)
	Tuberculous meningitis	1 (8.3)
Complications from preexisting hypertension (n=5)	Malignant hypertension	2 (40.0)
	Left ventricular failure	2 (40.0)
	Intracranial hemorrhage	1 (20.0)