title: Seasonal variations in maternal mortality in Maputo, Mozambique: the role of malaria.
abstract: OBJECTIVE
  To evaluate the impact of malaria on maternal death through the analysis of the seasonal variations of crude and malaria-specific maternal mortality rates.
  
  
  METHODS
  All maternal deaths and live births occurring at Maputo Central Hospital, located in an urban area, between January 2001 and December 2003, were retrospectively recorded. Clinical diagnoses of the causes of death and period of the year were analysed.
  
  
  RESULTS
  Two hundred and seventy-eight deaths were recorded. The overall crude maternal mortality rate was 995/100 000 live births. Malaria was the most frequent cause of maternal death, accounting for 23%. Crude and malaria-specific maternal mortality rates showed a similar pattern of seasonal variation, with peaks at the beginning and the end of the malaria transmission season. The malaria-specific maternal mortality rate was significantly higher during the rainy seasons (rate ratio 1.919; 95% CI 1.061, 3.470; P = 0.031).
  
  
  CONCLUSIONS
  Malaria may contribute to maternal mortality in highly endemic countries in sub-Saharan Africa, at least in urban areas. Efforts to improve malaria control in pregnancy may have an impact on maternal mortality in sub-Saharan Africa.
authors.affiliation: Department of Pathology, Hospital Clínic, University of Barcelona-Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain.
authors.forename: Cleofé
authors.initials: C
authors.lastname: Romagosa
authors.forename: Jaume
authors.initials: J
authors.lastname: Ordi
authors.forename: Francisco
authors.initials: F
authors.lastname: Saute
authors.forename: Llorenç
authors.initials: L
authors.lastname: Quintó
authors.forename: Fernanda
authors.initials: F
authors.lastname: Machungo
authors.forename: Mamudo R
authors.initials: MR
authors.lastname: Ismail
authors.forename: Carla
authors.initials: C
authors.lastname: Carrilho
authors.forename: Nafissa
authors.initials: N
authors.lastname: Osman
authors.forename: Pedro L
authors.initials: PL
authors.lastname: Alonso
authors.forename: Clara
authors.initials: C
authors.lastname: Menendez
mesh_terms: D000328:Adult; D002423:Cause of Death; D019353:Endemic Diseases; D005260:Female; D006801:Humans; D008288:Malaria / Q000401:mortality*; D008428:Maternal Mortality; D009073:Mozambique / Q000453:epidemiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000401:mortality*; D015597:Pregnancy Complications, Parasitic / Q000401:mortality; D012189:Retrospective Studies; D012621:Seasons