A retrospective study to understand the differences in maternal mortality among women admitted in critical and stable conditions in Malawi
Introduction Addressing the burden of preventable maternal deaths remains a critical focus of global health efforts in countries like Malawi which still has a high maternal mortality ratio of 381 deaths per 100 000 live births. We investigated the differences in case characteristics, survival and ca...
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BMJ Publishing Group
2025-01-01
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| Series: | BMJ Public Health |
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| author | David Lissauer James Chirombo Nara Tagiyeva-Milne Jennifer Riches Rosemary Bilesi Lumbani Makhaza Laura Munthali Malangizo Mbewe |
| author_facet | David Lissauer James Chirombo Nara Tagiyeva-Milne Jennifer Riches Rosemary Bilesi Lumbani Makhaza Laura Munthali Malangizo Mbewe |
| author_sort | David Lissauer |
| collection | DOAJ |
| description | Introduction Addressing the burden of preventable maternal deaths remains a critical focus of global health efforts in countries like Malawi which still has a high maternal mortality ratio of 381 deaths per 100 000 live births. We investigated the differences in case characteristics, survival and causes of death between pregnant and recently pregnant women who died, following their admission in stable or critical conditions to healthcare facilities in Malawi.Methods We conducted a retrospective analysis of maternal deaths of women from all district and central hospitals of Malawi between August 2020 and August 2022. Data were sourced from the national maternal and newborn health surveillance platform. We performed descriptive analyses, stratified by condition on admission, to identify differences in case characteristics between the two groups, and an exploratory survival analysis, to understand the differences in time to death since admission. Lastly, we performed a principal component analysis to reduce dimensionality to identify the main factors leading to deaths.Results Obstetric haemorrhage was the predominant cause of death among women admitted in stable condition, while those admitted in critical condition primarily died of hypertensive disorders. Most deaths in both categories occurred on the day of admission, corresponding to their primary causes of death. The key factors leading to deaths were mostly healthcare worker factors followed by administrative factors.Conclusion Understanding and responding to the different underlying causes of maternal mortality and contributing factors in the stable and critical cohorts are vital to designing well-targeted and impactful interventions to prevent maternal deaths. |
| format | Article |
| id | doaj-art-bdea9b6ca2d0446fbc67ea3c53bd40f5 |
| institution | Kabale University |
| issn | 2753-4294 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMJ Publishing Group |
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| spelling | doaj-art-bdea9b6ca2d0446fbc67ea3c53bd40f52025-01-20T08:05:14ZengBMJ Publishing GroupBMJ Public Health2753-42942025-01-013110.1136/bmjph-2024-001172A retrospective study to understand the differences in maternal mortality among women admitted in critical and stable conditions in MalawiDavid Lissauer0James Chirombo1Nara Tagiyeva-Milne2Jennifer Riches3Rosemary Bilesi4Lumbani Makhaza5Laura Munthali6Malangizo Mbewe7Maternal and Fetal Health Group, Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Blantyre, MalawiMalawi-Liverpool-Wellcome Trust Clinical Research Programme, Blantyre, MalawiFaculty of Education, Liverpool School of Tropical Medicine, Liverpool, UKWomen`s and Children`s Health, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UKReproductive Health Directorate, Government of Malawi Ministry of Health, Lilongwe, MalawiMalawi-Liverpool-Wellcome Trust Clinical Research Programme, Blantyre, MalawiMaternal and Fetal Health Group, Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Blantyre, MalawiMinistry of Health, Reproductive Health and Quality Management Directorates, Lilongwe, MalawiIntroduction Addressing the burden of preventable maternal deaths remains a critical focus of global health efforts in countries like Malawi which still has a high maternal mortality ratio of 381 deaths per 100 000 live births. We investigated the differences in case characteristics, survival and causes of death between pregnant and recently pregnant women who died, following their admission in stable or critical conditions to healthcare facilities in Malawi.Methods We conducted a retrospective analysis of maternal deaths of women from all district and central hospitals of Malawi between August 2020 and August 2022. Data were sourced from the national maternal and newborn health surveillance platform. We performed descriptive analyses, stratified by condition on admission, to identify differences in case characteristics between the two groups, and an exploratory survival analysis, to understand the differences in time to death since admission. Lastly, we performed a principal component analysis to reduce dimensionality to identify the main factors leading to deaths.Results Obstetric haemorrhage was the predominant cause of death among women admitted in stable condition, while those admitted in critical condition primarily died of hypertensive disorders. Most deaths in both categories occurred on the day of admission, corresponding to their primary causes of death. The key factors leading to deaths were mostly healthcare worker factors followed by administrative factors.Conclusion Understanding and responding to the different underlying causes of maternal mortality and contributing factors in the stable and critical cohorts are vital to designing well-targeted and impactful interventions to prevent maternal deaths.https://bmjpublichealth.bmj.com/content/3/1/e001172.full |
| spellingShingle | David Lissauer James Chirombo Nara Tagiyeva-Milne Jennifer Riches Rosemary Bilesi Lumbani Makhaza Laura Munthali Malangizo Mbewe A retrospective study to understand the differences in maternal mortality among women admitted in critical and stable conditions in Malawi BMJ Public Health |
| title | A retrospective study to understand the differences in maternal mortality among women admitted in critical and stable conditions in Malawi |
| title_full | A retrospective study to understand the differences in maternal mortality among women admitted in critical and stable conditions in Malawi |
| title_fullStr | A retrospective study to understand the differences in maternal mortality among women admitted in critical and stable conditions in Malawi |
| title_full_unstemmed | A retrospective study to understand the differences in maternal mortality among women admitted in critical and stable conditions in Malawi |
| title_short | A retrospective study to understand the differences in maternal mortality among women admitted in critical and stable conditions in Malawi |
| title_sort | retrospective study to understand the differences in maternal mortality among women admitted in critical and stable conditions in malawi |
| url | https://bmjpublichealth.bmj.com/content/3/1/e001172.full |
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