title: Maternal mortality trend in South East Nigeria: less than a decade to the millennium developmental goals.
abstract: OBJECTIVE
  Maternal mortality is increasing despite all global efforts to reverse the trend. In our environment, most studies were based on only a single health institution, leading to varying reports of ratios and causes of maternal death. We sought to determine the ratio, causes, and key risk factors of maternal deaths in institutions located at different socioeconomic settings.
  
  
  METHODS
  A retrospective study was carried out in two tertiary and two secondary healthcare institutions in Ebonyi state, Southeastern Nigeria over the 3-year period January 2003 to December 2005. All facilities had emergency obstetric services. Sociodemographic characteristics, causes of maternal death, and factors that contributed to the deaths were noted.
  
  
  RESULTS
  The maternal mortality ratio (MMR) was 902.7/100,000 live births. The ratio increased from 756.8 in 2003 to 897.6 in 2004 and then to 1052.2 in 2005. Major risk factors include grand multiparity, maternal age of > or =35 years, low socioeconomic status (SES), and unscheduled emergencies. The commonest cause of maternal death was sepsis (25.8%), followed by obstetric hemorrhage (23.7%). Preeclampsia/eclampsia and anemia accounted for 12.4% each. The MMR as well as the causes of maternal death varied among institutions.
  
  
  CONCLUSIONS
  The MMR is worsening. If this trend is not reversed, Nigeria may not be able to achieve the millennium developmental goal number 5 (MDG 5). A prospective, multicenter, community-based study is needed to fully assess the magnitude of the problem.
authors.affiliation: Department of Physiology/Obstetrics and Gynaecology, College of Medicine, University of Nigeria, Enugu, Nigeria. uchenwagha@yahoo.com
authors.forename: Uchenna Ifeanyi
authors.initials: UI
authors.lastname: Nwagha
authors.forename: Daniel
authors.initials: D
authors.lastname: Nwachukwu
authors.forename: Cyril
authors.initials: C
authors.lastname: Dim
authors.forename: Perpetus Chudi
authors.initials: PC
authors.lastname: Ibekwe
authors.forename: Azubuike
authors.initials: A
authors.lastname: Onyebuchi
mesh_terms: D000328:Adult; D002423:Cause of Death; D005260:Female; D006801:Humans; D008428:Maternal Mortality / Q000639:trends*; D009549:Nigeria / Q000453:epidemiology; D009790:Occupations / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012307:Risk Factors; D018454:Spouses / Q000706:statistics & numerical data