Maternal mortality rate in Fars Province: trends and associated factors in a community-based survey.
BACKGROUND
The high rate of maternal mortality (MM) remains a challenge, especially in developing countries. In 2000, the World Health Organization (WHO) targeted a 75% reduction by the end of 2015. In this survey, we determine trends in MM rates and associated factors in Fars Province, southwestern Iran.


METHODS
All MM in Fars Province from March 2003 to March 2010 were considered in this cross-sectional study. Data were recorded for demographic characteristics, autopsy findings, medical and obstetric histories. The data were then analyzed with a z-test to identify differences in the rate of MM during the study period.


RESULTS
The mean MM rate was 22.18 per 100 000 live births (95% CI, 17.55-26.8) during the seven year study period, and was highest (32.3/100 000) in the first year. Most deaths (71.3%) occurred in the postpartum period, and the lowest proportion occurred during delivery (5%). High-risk mothers accounted for 79.2% of maternal deaths. Among the mothers who died, 62% received satisfactory prenatal care, and at least two years elapsed between successive pregnancies in 78%. Hemorrhage was the main cause of death (35.6%) and the least frequent cause was H1N1 virus infection (2%).


CONCLUSIONS
This study provides evidence of serious deficiencies in postpartum care that need urgent action. Priority should be given to vaginal bleeding and high-risk status mothers.
Health Policy Research Center, Shiraz University of Medical Sciences, Iran.
Najmeh
N
Maharlouei
Zeinab
Z
Zakeri
Ezat
E
Mazloomi
Kamran Bagheri
KB
Lankarani
D000293:Adolescent; D000328:Adult; D002423:Cause of Death; D003430:Cross-Sectional Studies; D005260:Female; D006470:Hemorrhage / Q000208:ethnology; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype; D007251:Influenza, Human / Q000208:ethnology; D007492:Iran / Q000453:epidemiology; D008423:Maternal Age; D008428:Maternal Mortality / Q000208:ethnology / Q000639:trends*; D011181:Postnatal Care / Q000592:standards; D011787:Quality of Health Care; D055815:Young Adult