Causes and Risk Factors for Maternal Mortality in Rural Tanzania - Case of Rufiji Health and Demographic Surveillance Site (HDSS)

Illah Evance, Mbaruku Godfrey, Masanja Honorati, Kahn Kathleen

Abstract

Complications of childbirth and pregnancy are leading causes of death among women of reproductive age. Developing countries account for 99% of maternal deaths. The aim of this study was to explore levels, causes and risk factors associated with maternal mortality in rural Tanzania. Longitudinal data (2002-2006) from Rufiji HDSS was used where a total of 26 427 women aged 1549 years were included in the study; 64 died and there were 15 548 live births. Cox proportional hazards regression was used to assess the risk factors associated with maternal deaths. MMR was 412 per 100 000 live births. The main causes of death were haemorrhage (28%), eclampsia (19%) and puerperal sepsis (8%). An increased risk of 154% for maternal death was found for women aged 30-39 versus 15-19 years (HR=2.54, 95% CI=1.001-6.445). Married women had a protective effect of 62% over unmarried ones (HR=0.38, 95% CI=0.176-0.839). (Afr J Reprod Health 2013; 17[3]: 119-130). 

 

Résumé

Les complications de l'accouchement et de la grossesse sont les principales causes de décès chez les femmes en âge de procréer. Les pays en développement représentent 99% des décès maternels. Le but de cette étude était d'explorer les niveaux, les causes et les facteurs de risque associés à la mortalité maternelle dans les milieux ruraux  de Tanzanie. Les données longitudinales (20022006) de SSDS de Rufiji a été utilisé dans une étude où un total de 26 427 femmes âgées de 15-49 ans ont été incluses, 64 sont mortes et il y a eu 15 548 naissances vivantes. La  régression  proportionnelle de risques de Cox a été utilisée pour évaluer les facteurs de risque associés à la mortalité maternelle. Le TMM était de 412 pour 100 000 naissances vivantes. Les principales causes de décès étaient les hémorragies (28%), l'éclampsie (19%) et l'infection puerpérale (8%). L’on a enregistré un risque accru de 154% par rapport à la mortalité maternelle chez  les femmes âgées de 30-39 contre 15-19 ans (HR = 2,54, IC = 1,001 à 6,445 95%). Les femmes mariées avaient un effet protecteur de 62% par rapport aux femmes non mariés (HR = 0,38, IC = 0,176 à 0,839 95%). (Afr J Reprod Health 2013; 17[3]: 119-130).

 

Keywords: Maternal death, maternal mortality, risk factors and developing country

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