title: Trends in maternal mortality in Hungary between 1978 and 2010.
abstract: OBJECTIVE
  We evaluated the trends of the last decades in maternal mortality in Hungary and compared Hungarian results with those of other European countries.
  
  
  METHODS
  Cases of maternal death in Hungary during the study period from calendar year 1978 to 2010 were analyzed in a retrospective manner to characterize mortality distribution and to identify potential clinical or demographic predictors. Data in all cases were extracted both from the national Obstetric Registry operated by the National Institute of Gynecology and Obstetrics, from the Hungarian Central Bureau of Statistics and from the National Public Health and Medical Officer Service. Detailed clinical data were obtained based on obligatory reporting by individual clinical institutions.
  
  
  RESULTS
  The annual maternal mortality rate (MMR) was 26.7 per 100,000 live births in the period 1978-1987 and declined significantly to 10.9 per 100,000 live births in the period 1997-2010. In the period 1988-1996 (with missing associated clinical and demographic data) the MMR was 16.4 per 100,000 live births. The proportion of delivery-associated causes of death increased significantly between the two study periods from 49.4% to 62.9% (p<0.05). Among obstetric causes of death, the rate of thromboembolism showed a significant increase, while there was a trend toward a decline in rate of maternal deaths attributable to hemorrhagic shock. Among medical causes of death not directly attributable to obstetric complications, the rate of renal and gastrointestinal etiologies declined significantly throughout the study periods.
  
  
  CONCLUSIONS
  We observed a marked decline in maternal mortality during the last few decades in Hungary. Recent changes in mortality distribution highlight current characteristics of pregnancy care in Hungary and may help identify strategies for future improvement.
authors.affiliation: Semmelweis University, Faculty of Medicine, First Department of Gynecology and Obstetrics, Budapest, Hungary.
authors.forename: János
authors.initials: J
authors.lastname: Rigó
authors.affiliation: Department of Gynecology and Obstetrics, Dél-Pesti Hospital, Budapest, Hungary.
authors.forename: György
authors.initials: G
authors.lastname: Csákány
authors.affiliation: Semmelweis University, Faculty of Medicine, First Department of Gynecology and Obstetrics, Budapest, Hungary.
authors.forename: Marcella
authors.initials: M
authors.lastname: Laky
authors.affiliation: Semmelweis University, Faculty of Medicine, First Department of Gynecology and Obstetrics, Budapest, Hungary.
authors.forename: Bálint
authors.initials: B
authors.lastname: Nagy
authors.affiliation: Semmelweis University, Faculty of Medicine, First Department of Gynecology and Obstetrics, Budapest, Hungary.
authors.forename: Endre
authors.initials: E
authors.lastname: Horváth
authors.affiliation: Semmelweis University, Faculty of Medicine, First Department of Gynecology and Obstetrics, Budapest, Hungary. Electronic address: joogabor@hotmail.com.
authors.forename: József Gábor
authors.initials: JG
authors.lastname: Joó
mesh_terms: D000328:Adult; D000367:Age Factors; D002423:Cause of Death; D016208:Databases, Factual; D005260:Female; D006801:Humans; D006814:Hungary / Q000453:epidemiology; D008428:Maternal Mortality / Q000639:trends*; D008875:Middle Aged; D011247:Pregnancy; D011248:Pregnancy Complications / Q000401:mortality*; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult
keywords: Indirect causes of maternal death; Maternal mortality; Obstetric causes of maternal death; Thromboembolic complications of pregnancy