title: How many maternal deaths are there in Portugal?
abstract: BACKGROUND
  Maternal mortality is a public health issue, internationally considered an indicator of women's status in society, indirectly translating access to health facilities. However, it is difficult to measure and is usually underestimated by official records.
  
  
  METHODS
  Maternal deaths missed by the official statistics in Portugal between 2001 and 2006 were estimated by multiple-recapture methods using three different data sources. An upper limit to the number of deaths was derived from the application of the mortality function of women in reproductive age to the estimated annual number of pregnancies.
  
  
  RESULTS
  Maternal mortality decreased from 40 to less than 10 deaths per 100,000 live births between 1978 and 1986. Between 2001 and 2006, it varied from 2.5 to 19 and was underestimated by 9%-26%. Nevertheless, within the same age range, the risk of a pregnant women to die was four times less than a women in the general population.
  
  
  CONCLUSIONS
  Like in other developed countries, official statistics in Portugal have systematically underestimated maternal deaths. These deaths are a rare event, but the consistent increase in the average age at pregnancy may exacerbate the main causes of death, raising concerns for the future and prompting the need for emergency facilities nearby maternities.
authors.affiliation: Faculty of Sciences, University of Lisbon, Campo Grande, Lisbon, Portugal.
authors.forename: Manuel C
authors.initials: MC
authors.lastname: Gomes
authors.forename: Maria T
authors.initials: MT
authors.lastname: Ventura
authors.forename: Rui S
authors.initials: RS
authors.lastname: Nunes
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D016014:Linear Models; D008428:Maternal Mortality / Q000639:trends*; D008875:Middle Aged; D011174:Portugal / Q000453:epidemiology; D011247:Pregnancy; D012042:Registries; D055815:Young Adult