[The reduction in maternal mortality in Chile, 1990-2000].
OBJECTIVE
To determine if Chile achieved the objective of reducing maternal mortality by 50% between 1990 and 2000, in line with the provisions of the Regional Plan of Action for the Reduction of Maternal Mortality in the Americas, which the governments of the Americas approved in 1990 at the 23rd Pan American Sanitary Conference.


METHODS
A descriptive, observational study was designed, making it possible to analyze the trend in maternal mortality in Chile from 1990 through 2000. The variables that were evaluated were the maternal mortality ratio, the causes of death, and the age of the mothers who died. The causes of death were classified according to the ninth revision of the International Classification of Diseases (ICD-9), and the raw data were obtained from the yearbooks of the National Institute of Statistics of Chile. The changes in the variables were estimated according to the percentage of cumulative change, and trends were analyzed with the Pearson correlation coefficient.


RESULTS
The study found a 60.3% reduction in maternal mortality from 1990 to 2000. The lowest maternal mortality ratio, 18.7 per 100 000 live births, occurred in the year 2000. The five leading causes of maternal mortality were hypertension, miscarriage, other current conditions in the mother, puerperal sepsis, and postpartum hemorrhage. There was a significant downward trend in maternal mortality due to hypertension (r = -0.712; P = 0.014), abortion (r = -0.810; P = 0.003), and puerperal sepsis (r = -0.718; P = 0.013), but there were no statistically significant changes in mortality from other current conditions in the mother or from postpartum hemorrhage. The highest level of maternal mortality was found in women who were 40 years of age or older (100.2/100 000 live births), and the lowest level was in adolescents 15 to 19 years old (18.7/100 000 live births).


CONCLUSIONS
Chile achieved the objective of the Regional Plan of Action for the Reduction of Maternal Mortality in the Americas, with a decrease of more than 50% in maternal mortality in the 1990-2000 period. That reduction is due mainly to the decline in maternal mortality from hypertension, abortion, and puerperal sepsis.
Donoso Siña
Enrique
E
Pontificia Universidad Católica de Chile, Facultad de Medicina, Departamento de Obstetricia y Ginecología, Santiago, Chile. edonoso@med.puc.cl
D000293:Adolescent; D000328:Adult; D002677:Chile / Q000453:epidemiology; D005260:Female; D006801:Humans; D008428:Maternal Mortality / Q000639:trends*