Determinants of Post-Partum Maternal Mortality at Queen Elizabeth Central Hospital, Blantyre, Malawi: A Case-Control Study 2001-2002
), Channon, A.(2), Tadesse, E(3), Madise, N.(4), Changole, J.(5), Bakuwa, E.(6), Malunga, E(7), Stones, R.W(8),
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Corresponding Author
Abstract
The aim of this research is to identify the clinical, demographic and service-based determinants of postpartum maternal mortality within Queen Elizabeth Central Hospital, Blantyre, Malawi, during 2001 and 2002. The study uses a case-control design using all postpartum maternal deaths in 2001 and 2002 as cases, with analysis conducted using conditional logistic regression. The results indicate that the mothers’ reason for admission into hospital and the outcome of the birth were significantly related to maternal death when analysing all potential explanatory variables in one model. A group of high-risk mothers can be identified using these factors. If these criteria were applied as a predictive tool in the clinical setting the resulting sensitivity and specificity would be over 85%. Identification within the hospital setting of a group of very high-risk mothers in whom serious complications are aggressively managed in a coordinated way across the medical specialties may reduce maternal mortality (Afr J Reprod Health 2008; 12[3]:35-48).
RĖSUMĖ
Les déterminants de mortalité maternelle post-partum à Queen Elizabeth Hospital, Blantyre, Malawi : Etude de contrôle de cas 2001 – 2002 Cette recherche a pour but d'identifier les déterminants cliniques, démographiques et à base de service de mortalité maternelle postpartum à Elisabeth Central Hospital, Blantyre, Malawi, pendant 2001 et 2002. L'étude utilise une conception de contrôle de cas utilisant toutes les morts maternelles postpartum en 2001 et 2002 comme des cas, avec l'analyse conduite utilisant la régression logistique conditionnelle. Les résultats indiquent que la raison pour laquelle la mère est admise dans l'hôpital et le résultat de la naissance ont été significativement rapprochés de la mort maternelle en analysant toutes les variables potentielles explicatives dans un modèle. Un groupe de mères à haut risque peut être identifié utilisant ces facteurs. Si ces critères ont été appliqués comme un outil prophétique dans l'arrangement clinique, la sensibilité résultante et la spécificité seraient plus de 85 %. L'identification dans le cadre d'hôpital d'un groupe de mères à haut risque dont des complications sérieuses sont agressivement gérées d'une façon coordonnée à travers les souvenirs médicaux peut réduire la mortalité maternelle (Afr J Reprod Health 2008; 12[3]:35-48).
KEY WORDS: Postpartum Maternal Mortality; Case-control; High-risk Groups; Malawi
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