Une étude prospective de la mortalité maternelle, foetale et néonatale dans les pays à revenus faible et intermédiaire

Translated title of the contribution: A prospective study of maternal, fetal and neonatal deaths in low- and middle-income countries

Sarah Saleem, Elizabeth M. McClure, Shivaprasad S. Goudar, Archana Patel, Fabian Esamai, Ana Garces, Elwyn Chomba, Fernando Althabe, Janet Moore, Bhalachandra Kodkany, Omrana Pasha, Jose Belizan, Albert Mayansyan, Richard J. Derman, Patricia L. Hibberd, Edward A. Liechty, Nancy F. Krebs, K. Michael Hambidge, Pierre Buekens, Waldemar A. CarloLinda L. Wright, Marion Koso-Thomas, Alan H. Jobe, Robert L. Goldenberg, Mabel Berrueta, Marta Lidia Aguilar, S. M. Dhaded, N. V. Honnungar, M. S. Somannavar, S. C. Mastiholi, B. M. Tenginkai, Umesh Ramdurg, Manju Waikar, Nivedita Kulkarni, Sushama Thakre, Manoj Bhatnagar, Peter Gisore, Hillary Mbeya, Neelofar Sami, Khadim Hussain, Dennis D. Wallace, Melody Chiwila

Research output: Contribution to journalArticle

63 Citations (Scopus)

Abstract

Objective: To quantify maternal, fetal and neonatal mortality in low- and middle-income countries, to identify when deaths occur and to identify relationships between maternal deaths and stillbirths and neonatal deaths. Methods: A prospective study of pregnancy outcomes was performed in 106 communities at seven sites in Argentina, Guatemala, India, Kenya, Pakistan and Zambia. Pregnant women were enrolled and followed until six weeks postpartum. Findings: Between 2010 and 2012, 214 070 of 220 235 enrolled women (97.2%) completed follow-up. The maternal mortality ratio was 168 per 100 000 live births, ranging from 69 per 100 000 in Argentina to 316 per 100 000 in Pakistan. Overall, 29% (98/336) of maternal deaths occurred around the time of delivery: most were attributed to haemorrhage (86/336), pre-eclampsia or eclampsia (55/336) or sepsis (39/336). Around 70% (4349/6213) of stillbirths were probably intrapartum; 34% (1804/5230) of neonates died on the day of delivery and 14% (755/5230) died the day after. Stillbirths were more common in women who died than in those alive six weeks postpartum (risk ratio, RR: 9.48; 95% confidence interval, CI: 7.97-11.27), as were perinatal deaths (RR: 4.30; 95% CI: 3.26-5.67) and 7-day (RR: 3.94; 95% CI: 2.74-5.65) and 28-day neonatal deaths (RR: 7.36; 95% CI: 5.54-9.77). Conclusion: Most maternal, fetal and neonatal deaths occurred at or around delivery and were attributed to preventable causes. Maternal death increased the risk of perinatal and neonatal death. Improving obstetric and neonatal care around the time of birth offers the greatest chance of reducing mortality.

Original languageFrench
Pages (from-to)605-612
Number of pages8
JournalBulletin of the World Health Organization
Volume92
Issue number8
DOIs
StatePublished - 2014

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Maternal Death
Fetal Death
Prospective Studies
Stillbirth
Maternal Mortality
Pakistan
Argentina
Postpartum Period
Guatemala
Fetal Mortality
Zambia
Eclampsia
Kenya
Live Birth
Infant Mortality
Pregnancy Outcome
Pre-Eclampsia
Obstetrics
Perinatal Death
Pregnant Women

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

Une étude prospective de la mortalité maternelle, foetale et néonatale dans les pays à revenus faible et intermédiaire. / Saleem, Sarah; McClure, Elizabeth M.; Goudar, Shivaprasad S.; Patel, Archana; Esamai, Fabian; Garces, Ana; Chomba, Elwyn; Althabe, Fernando; Moore, Janet; Kodkany, Bhalachandra; Pasha, Omrana; Belizan, Jose; Mayansyan, Albert; Derman, Richard J.; Hibberd, Patricia L.; Liechty, Edward A.; Krebs, Nancy F.; Hambidge, K. Michael; Buekens, Pierre; Carlo, Waldemar A.; Wright, Linda L.; Koso-Thomas, Marion; Jobe, Alan H.; Goldenberg, Robert L.; Berrueta, Mabel; Aguilar, Marta Lidia; Dhaded, S. M.; Honnungar, N. V.; Somannavar, M. S.; Mastiholi, S. C.; Tenginkai, B. M.; Ramdurg, Umesh; Waikar, Manju; Kulkarni, Nivedita; Thakre, Sushama; Bhatnagar, Manoj; Gisore, Peter; Mbeya, Hillary; Sami, Neelofar; Hussain, Khadim; Wallace, Dennis D.; Chiwila, Melody.

In: Bulletin of the World Health Organization, Vol. 92, No. 8, 2014, p. 605-612.

Research output: Contribution to journalArticle

Saleem, S, McClure, EM, Goudar, SS, Patel, A, Esamai, F, Garces, A, Chomba, E, Althabe, F, Moore, J, Kodkany, B, Pasha, O, Belizan, J, Mayansyan, A, Derman, RJ, Hibberd, PL, Liechty, EA, Krebs, NF, Hambidge, KM, Buekens, P, Carlo, WA, Wright, LL, Koso-Thomas, M, Jobe, AH, Goldenberg, RL, Berrueta, M, Aguilar, ML, Dhaded, SM, Honnungar, NV, Somannavar, MS, Mastiholi, SC, Tenginkai, BM, Ramdurg, U, Waikar, M, Kulkarni, N, Thakre, S, Bhatnagar, M, Gisore, P, Mbeya, H, Sami, N, Hussain, K, Wallace, DD & Chiwila, M 2014, 'Une étude prospective de la mortalité maternelle, foetale et néonatale dans les pays à revenus faible et intermédiaire', Bulletin of the World Health Organization, vol. 92, no. 8, pp. 605-612. https://doi.org/10.2471/BLT.13.127464
Saleem, Sarah ; McClure, Elizabeth M. ; Goudar, Shivaprasad S. ; Patel, Archana ; Esamai, Fabian ; Garces, Ana ; Chomba, Elwyn ; Althabe, Fernando ; Moore, Janet ; Kodkany, Bhalachandra ; Pasha, Omrana ; Belizan, Jose ; Mayansyan, Albert ; Derman, Richard J. ; Hibberd, Patricia L. ; Liechty, Edward A. ; Krebs, Nancy F. ; Hambidge, K. Michael ; Buekens, Pierre ; Carlo, Waldemar A. ; Wright, Linda L. ; Koso-Thomas, Marion ; Jobe, Alan H. ; Goldenberg, Robert L. ; Berrueta, Mabel ; Aguilar, Marta Lidia ; Dhaded, S. M. ; Honnungar, N. V. ; Somannavar, M. S. ; Mastiholi, S. C. ; Tenginkai, B. M. ; Ramdurg, Umesh ; Waikar, Manju ; Kulkarni, Nivedita ; Thakre, Sushama ; Bhatnagar, Manoj ; Gisore, Peter ; Mbeya, Hillary ; Sami, Neelofar ; Hussain, Khadim ; Wallace, Dennis D. ; Chiwila, Melody. / Une étude prospective de la mortalité maternelle, foetale et néonatale dans les pays à revenus faible et intermédiaire. In: Bulletin of the World Health Organization. 2014 ; Vol. 92, No. 8. pp. 605-612.
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abstract = "Objective: To quantify maternal, fetal and neonatal mortality in low- and middle-income countries, to identify when deaths occur and to identify relationships between maternal deaths and stillbirths and neonatal deaths. Methods: A prospective study of pregnancy outcomes was performed in 106 communities at seven sites in Argentina, Guatemala, India, Kenya, Pakistan and Zambia. Pregnant women were enrolled and followed until six weeks postpartum. Findings: Between 2010 and 2012, 214 070 of 220 235 enrolled women (97.2{\%}) completed follow-up. The maternal mortality ratio was 168 per 100 000 live births, ranging from 69 per 100 000 in Argentina to 316 per 100 000 in Pakistan. Overall, 29{\%} (98/336) of maternal deaths occurred around the time of delivery: most were attributed to haemorrhage (86/336), pre-eclampsia or eclampsia (55/336) or sepsis (39/336). Around 70{\%} (4349/6213) of stillbirths were probably intrapartum; 34{\%} (1804/5230) of neonates died on the day of delivery and 14{\%} (755/5230) died the day after. Stillbirths were more common in women who died than in those alive six weeks postpartum (risk ratio, RR: 9.48; 95{\%} confidence interval, CI: 7.97-11.27), as were perinatal deaths (RR: 4.30; 95{\%} CI: 3.26-5.67) and 7-day (RR: 3.94; 95{\%} CI: 2.74-5.65) and 28-day neonatal deaths (RR: 7.36; 95{\%} CI: 5.54-9.77). Conclusion: Most maternal, fetal and neonatal deaths occurred at or around delivery and were attributed to preventable causes. Maternal death increased the risk of perinatal and neonatal death. Improving obstetric and neonatal care around the time of birth offers the greatest chance of reducing mortality.",
author = "Sarah Saleem and McClure, {Elizabeth M.} and Goudar, {Shivaprasad S.} and Archana Patel and Fabian Esamai and Ana Garces and Elwyn Chomba and Fernando Althabe and Janet Moore and Bhalachandra Kodkany and Omrana Pasha and Jose Belizan and Albert Mayansyan and Derman, {Richard J.} and Hibberd, {Patricia L.} and Liechty, {Edward A.} and Krebs, {Nancy F.} and Hambidge, {K. Michael} and Pierre Buekens and Carlo, {Waldemar A.} and Wright, {Linda L.} and Marion Koso-Thomas and Jobe, {Alan H.} and Goldenberg, {Robert L.} and Mabel Berrueta and Aguilar, {Marta Lidia} and Dhaded, {S. M.} and Honnungar, {N. V.} and Somannavar, {M. S.} and Mastiholi, {S. C.} and Tenginkai, {B. M.} and Umesh Ramdurg and Manju Waikar and Nivedita Kulkarni and Sushama Thakre and Manoj Bhatnagar and Peter Gisore and Hillary Mbeya and Neelofar Sami and Khadim Hussain and Wallace, {Dennis D.} and Melody Chiwila",
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TY - JOUR

T1 - Une étude prospective de la mortalité maternelle, foetale et néonatale dans les pays à revenus faible et intermédiaire

AU - Saleem, Sarah

AU - McClure, Elizabeth M.

AU - Goudar, Shivaprasad S.

AU - Patel, Archana

AU - Esamai, Fabian

AU - Garces, Ana

AU - Chomba, Elwyn

AU - Althabe, Fernando

AU - Moore, Janet

AU - Kodkany, Bhalachandra

AU - Pasha, Omrana

AU - Belizan, Jose

AU - Mayansyan, Albert

AU - Derman, Richard J.

AU - Hibberd, Patricia L.

AU - Liechty, Edward A.

AU - Krebs, Nancy F.

AU - Hambidge, K. Michael

AU - Buekens, Pierre

AU - Carlo, Waldemar A.

AU - Wright, Linda L.

AU - Koso-Thomas, Marion

AU - Jobe, Alan H.

AU - Goldenberg, Robert L.

AU - Berrueta, Mabel

AU - Aguilar, Marta Lidia

AU - Dhaded, S. M.

AU - Honnungar, N. V.

AU - Somannavar, M. S.

AU - Mastiholi, S. C.

AU - Tenginkai, B. M.

AU - Ramdurg, Umesh

AU - Waikar, Manju

AU - Kulkarni, Nivedita

AU - Thakre, Sushama

AU - Bhatnagar, Manoj

AU - Gisore, Peter

AU - Mbeya, Hillary

AU - Sami, Neelofar

AU - Hussain, Khadim

AU - Wallace, Dennis D.

AU - Chiwila, Melody

PY - 2014

Y1 - 2014

N2 - Objective: To quantify maternal, fetal and neonatal mortality in low- and middle-income countries, to identify when deaths occur and to identify relationships between maternal deaths and stillbirths and neonatal deaths. Methods: A prospective study of pregnancy outcomes was performed in 106 communities at seven sites in Argentina, Guatemala, India, Kenya, Pakistan and Zambia. Pregnant women were enrolled and followed until six weeks postpartum. Findings: Between 2010 and 2012, 214 070 of 220 235 enrolled women (97.2%) completed follow-up. The maternal mortality ratio was 168 per 100 000 live births, ranging from 69 per 100 000 in Argentina to 316 per 100 000 in Pakistan. Overall, 29% (98/336) of maternal deaths occurred around the time of delivery: most were attributed to haemorrhage (86/336), pre-eclampsia or eclampsia (55/336) or sepsis (39/336). Around 70% (4349/6213) of stillbirths were probably intrapartum; 34% (1804/5230) of neonates died on the day of delivery and 14% (755/5230) died the day after. Stillbirths were more common in women who died than in those alive six weeks postpartum (risk ratio, RR: 9.48; 95% confidence interval, CI: 7.97-11.27), as were perinatal deaths (RR: 4.30; 95% CI: 3.26-5.67) and 7-day (RR: 3.94; 95% CI: 2.74-5.65) and 28-day neonatal deaths (RR: 7.36; 95% CI: 5.54-9.77). Conclusion: Most maternal, fetal and neonatal deaths occurred at or around delivery and were attributed to preventable causes. Maternal death increased the risk of perinatal and neonatal death. Improving obstetric and neonatal care around the time of birth offers the greatest chance of reducing mortality.

AB - Objective: To quantify maternal, fetal and neonatal mortality in low- and middle-income countries, to identify when deaths occur and to identify relationships between maternal deaths and stillbirths and neonatal deaths. Methods: A prospective study of pregnancy outcomes was performed in 106 communities at seven sites in Argentina, Guatemala, India, Kenya, Pakistan and Zambia. Pregnant women were enrolled and followed until six weeks postpartum. Findings: Between 2010 and 2012, 214 070 of 220 235 enrolled women (97.2%) completed follow-up. The maternal mortality ratio was 168 per 100 000 live births, ranging from 69 per 100 000 in Argentina to 316 per 100 000 in Pakistan. Overall, 29% (98/336) of maternal deaths occurred around the time of delivery: most were attributed to haemorrhage (86/336), pre-eclampsia or eclampsia (55/336) or sepsis (39/336). Around 70% (4349/6213) of stillbirths were probably intrapartum; 34% (1804/5230) of neonates died on the day of delivery and 14% (755/5230) died the day after. Stillbirths were more common in women who died than in those alive six weeks postpartum (risk ratio, RR: 9.48; 95% confidence interval, CI: 7.97-11.27), as were perinatal deaths (RR: 4.30; 95% CI: 3.26-5.67) and 7-day (RR: 3.94; 95% CI: 2.74-5.65) and 28-day neonatal deaths (RR: 7.36; 95% CI: 5.54-9.77). Conclusion: Most maternal, fetal and neonatal deaths occurred at or around delivery and were attributed to preventable causes. Maternal death increased the risk of perinatal and neonatal death. Improving obstetric and neonatal care around the time of birth offers the greatest chance of reducing mortality.

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