title: Maternal mortality secondary to acute respiratory failure in Colombia: a population-based analysis.
abstract: OBJECTIVE
  To estimate the mortality rate and trends of respiratory failure in the pregnant and postpartum population of Colombia.
  
  
  METHODS
  A retrospective analysis of the national registry of mortality in Colombia was performed from 1998 to 2009. Maternal death was defined as death that occurred during pregnancy or up to 42 days postpartum. Two independent investigators reviewed maternal deaths to determine deaths caused by respiratory failure. Inter-rater agreement was assessed by kappa correlation coefficient. Causes of respiratory failure were identified according to the International Classification of Diseases (ICD-10).
  
  
  RESULTS
  During the study period, 8,637,486 live births were reported with 6,676 maternal deaths for an overall maternal mortality rate (MMR) of 82.9 per 100,000 live births. Of these, a total of 835 cases were related to respiratory failure, with a specific MMR of 9.69 per 100,000 live births. The main causes of maternal deaths due to respiratory failure included pulmonary sepsis (284 cases, or 3.58 per 100,000 live births), pulmonary embolism (119 cases or 1.50 per 100,000 live births), and preeclampsia-related pulmonary edema (112 cases or 1.41 per 100,000 live births). All-cause maternal mortality ratio decreased yearly from 1998 to 2009 by -3.76% (95% CI -4.83 to -2.67), while the trend of mortality secondary to respiratory failure remained stable over time (P = 0.449).
  
  
  CONCLUSIONS
  Respiratory failure is an important cause of mortality in the obstetric population in Colombia, with pulmonary sepsis as the lead cause of respiratory failure among maternal deaths. While overall maternal mortality rates have decreased in the last decade, respiratory failure-related deaths have remained stable over time.
authors.affiliation: Grupo de Investigación en Cuidados Intensivos y Obstetricia - GRICIO, Universidad de Cartagena, Cartagena, Colombia, joseantonio.rojas.suarez@gmail.com.
authors.forename: José
authors.initials: J
authors.lastname: Rojas-Suarez
authors.forename: Camilo
authors.initials: C
authors.lastname: Bello-Muñoz
authors.forename: Angel
authors.initials: A
authors.lastname: Paternina-Caicedo
authors.forename: Ghada
authors.initials: G
authors.lastname: Bourjeily
authors.forename: Gerardo
authors.initials: G
authors.lastname: Carino
authors.forename: Carmelo
authors.initials: C
authors.lastname: Dueñas
mesh_terms: D000208:Acute Disease; D000328:Adult; D003105:Colombia / Q000453:epidemiology; D005260:Female; D006801:Humans; D050498:Live Birth; D008428:Maternal Mortality / Q000639:trends; D049590:Postpartum Period; D011225:Pre-Eclampsia / Q000401:mortality; D011247:Pregnancy; D011654:Pulmonary Edema / Q000150:complications / Q000401:mortality; D011655:Pulmonary Embolism / Q000150:complications / Q000401:mortality; D012131:Respiratory Insufficiency / Q000209:etiology / Q000401:mortality*; D012189:Retrospective Studies; D018805:Sepsis / Q000150:complications / Q000401:mortality; D055815:Young Adult