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An Exploratory Study Into Social and Healthcare Variables of Maternal Mortality: A Case-Control Study Publisher Pubmed



Nosratabadi M1, 2 ; Rarani MA3, 4 ; Shahidi S5 ; Rahimi N6
Authors
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Authors Affiliations
  1. 1. Social Determinants of Health Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
  2. 2. Department of Health and Social Welfare, School of Management and Medical Information Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
  3. 3. Social Determinants of Health Research Cntr., Isfahan University of Medical Sciences, Isfahan, 81746 73461, Iran
  4. 4. School of Management and Medical Information Sciences, Isfahan University of Medical Sciences, HezarJerib Ave., Isfahan, 81746 73461, Iran
  5. 5. Social Determinants of Health Research Center, Deputy of Social, Isfahan University of Medical Sciences, Isfahan, Iran
  6. 6. Deputy of Health, Isfahan University of Medical Sciences, Isfahan, Iran

Source: Journal of Perinatal Medicine Published:2019


Abstract

Regarding the important role the mothers' health plays in shaping nations' well-being, this study endeavored to explore the main social and healthcare factors related to maternal mortality. In this case-control study, data (viz., all maternal mortalities) were gathered from the national maternal mortality surveillance system. Likewise, control data (viz., alive mothers) were obtained from mother health records in 22 health centers located in 21 cities of Isfahan, Iran. The data were related to the years 2001-2016. Case and control groups were matched according to year of delivery, mother's age at delivery time and city of residence. Analysis of the gathered data revealed that during the years 2001-2016, 171 maternal mortalities occurred in Isfahan. In view of that, 523 mothers were selected as the control group. Most of the mothers attended high school (36%), were housewives (64%), delivered by cesarean section (59%) and suffered from different kinds of proximate medical causes (55%). The logistic regression results showed that being an immigrant, having a history of proximate medical cause, vaginal delivery and illiteracy raised the odds ratios (ORs) of maternal mortality up to 5.87, 4.41, 2.28 and 1.84 times, respectively. In contrast, using public antenatal care and planned pregnancy have had a protective, significant effect on maternal mortality (ORs <1). The results suggested that in addition to social factors including immigrant status and low level of education which led to the increase of maternal mortality, healthcare factors including proximate medical causes, delivery method and antenatal care seem to be essential in tackling the issue of maternal mortality. © 2019 Walter de Gruyter GmbH, Berlin/Boston.
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