Maternal Mortality in a Nigerian Maternity Hospital

Despite recent focus on maternal mortality in Nigeria, its rates remain unacceptably high in Nigeria. A retrospective case-control study was carried out at Adeoyo Maternity Hospital, Ibadan between January 2003 and December 2004. This was to determine the maternal mortality ratio in a secondary health facility, to identify the causes of death and to assess factors associated with these deaths. The case files of all maternal deaths that occurred in the hospital during the two years period were retrieved and data extracted into a study proforma. Each maternal death was matched with three controls that delivered the same day and live around the same area of Ibadan. Bivariate analysis of the data was done with the cases and controls compared in relation to various risk factors. There were 8,724 lives births and 84 maternal deaths giving a MMR of 963/100,000 live births. The main causes of the death were haemorrhage 20 (23.8%) sepsis 20 (23.8%) and eclampsia 14(16.7%). Nine women (10.7%) died while pregnant, 11 (13.1%) died in labour, 53 (63.1%) died after delivery while 11 (13.1%) died from post-abortal complications. Most of the deaths due to post-partum heamorrhage (66.7%) were seen in mothers over the age of 29 years while 64.2% of deaths due to eclampsia were in women under the age of 25 years due to eclampsia occurred in nulliparous women and PPH was responsible for deaths in more women as their parity increased from two. From bivariate analysis, factors significantly associated with maternal death included unbooked status {Odd’s ratio OR=12.89 (95%C.I. _ 6.9 – 24.1) p<0.05}, grandmultiparity (parity>5) {OR=4.17 (95% C.I. – 1.53-11.45) p< 0.05} and prolonged labour (>18 hours) {OR=2.86, (95% C.I. 1.5 – 5.9) p< 0.05}. It is necessary to improve the quality of emergency obstetric service as well as reduce the cost and to educate women of reproductive age in Ibadan on the importance of booking for antenatal care and family planning.

Keywords
Maternal mortality, case-control study, maternal death, antenatal care, emergency obstetric care