Trends in maternal mortality in a tertiary institution in Northern Nigeria

Objective: To look at the trends in maternal mortality in our institution over 5 years.
Methods: Records of 112 maternal deaths were retrospectively reviewed to determine the trends and the likely direct cause of each death over the study period.
Results: There were a total of 112 maternal deaths, while 3931 deliveries were conducted over the 5-year period. The maternal mortality ratio (MMR) was 2849/100,000 deliveries. The highest MMR of 6234/100,000 was observed in 2003, with remarkable decline to 1837/100,000 in 2007. Eclampsia consistently remained the leading cause, accounting for 46.4% of the maternal deaths, followed by sepsis and postpartum hemorrhage (PPH) contributing 17% and 14.3%, respectively. There were no statistically significant differences in the corresponding percentages of maternal deaths between various age groups (χ²=6.68; P =0.083). Grandmultiparas accounted for a significant proportion of maternal deaths as compared to low parity, with χ²=10.43; P =0.00054. Lack of seeking antenatal care (unbooked) and illiteracy were observed to be significant determinants of maternal mortality (χ²=64.69, P =0.00000; and χ²=18.52, P =0.0000168, respectively).
Conclusion: In spite of decrease in the maternal mortality ratio over the years, it still remains high, with eclampsia persistently contributing most significantly. Community enlightenment on the need to avail of antenatal care and hospital delivery services, and improvement in the quality of skilled maternity care will, among other factors, drastically curtail these preventable causes of maternal death and reduce MMR.