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Maternal deaths in Iceland over 25 years.

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Authors
Birgisdottir, Hera
Bjarnadottir, Ragnheidur I
Kristjansdottir, Katrin
Geirsson, Reynir T
Issue Date
2016-01

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Citation
Maternal deaths in Iceland over 25 years. 2016, 95 (1):74-8 Acta Obstet Gynecol Scand
Abstract
Maternal death, during pregnancy or within 42 and 365 days from the end of pregnancy, was evaluated for a small high-income nation with comprehensive healthcare.
Cases were identified using record linkage by running national census information on all deaths of women aged 15-49 years during 1985-2009 against the national birth register and computerized hospital admission files for pregnancy-related diagnoses as well as actual case records where needed. Death certificates and hospital records were reviewed.
Thirty deaths were identified; 26 at ≥22 weeks (= birth) and four earlier in pregnancy. For 107 871 deliveries, the overall mortality was 27.8/100 000. There were five direct deaths (4.6/100 000 deliveries), five indirect deaths (4.6/100 000 deliveries) and 19 coincidental deaths (17.6/100 000 deliveries). Using WHO criteria (direct and indirect in pregnancy or at ≤42 days postpartum) the ratio was 5.6/100 000 deliveries (95% confidence interval 1.1-10.1) and 5.5/100 000 live births (maternal mortality ratio, based on six deaths). Direct deaths were caused by sepsis, severe preeclampsia and choriocarcinoma, indirect by suicide, pre-existing cardiac and diabetic illness. No woman died of postpartum hemorrhage, anesthesia or ectopic pregnancy. Suboptimal care occurred.
Maternal mortality in Iceland over a 25-year period up to the end of year 2010 was low, between 5 and 6/100 000 births. A comprehensive national healthcare system with accessible antenatal care in a society with good general living conditions and universal education probably contributed to this.
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Additional Links
http://dx.doi.org/ 10.1111/aogs.12797
http://onlinelibrary.wiley.com/doi/10.1111/aogs.12797/epdf
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Archived with thanks to Acta obstetricia et gynecologica Scandinavica
ae974a485f413a2113503eed53cd6c53
10.1111/aogs.12797
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