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The global maternal mortality ratio was 400 deaths per 100,000 live
births in 2005 and was almost the same as the rate in 1990. (1). As to
causes of death, about 80% of global maternal deaths are attributed to
direct causes such as haemorrhage, infections and eclampsia, whilst
indirect causes including cardiac disease are less common (2). In the UK,
in contrast, indirect causes accounted for more than half of maternal
mortality and cardiac disease became the commonest cause of maternal death
according to the latest report (2003ƒ{2005) from Confidential Enquiries
into Maternal and Child Health (CEMACH) (3). Although the maternal
mortality rate in the UK is low, 14 per 100,000, the problem is that it
has not improved in the last 20 years, in fact there has been a slight
increase. This increase is mainly due to a steady rise in maternal deaths
from cardiac disease as an indirect cause over that period. Pulmonary
embolism remains the leading direct cause, but cardiopulmonary causes now
account for one third of maternal deaths in the UK. We have recently
completed a study (4} on these cardiopulmonary cases linking them to
genetic cardiac disease and also obesity. I wonder if in USA , the causes
of maternal mortality are due to direct causes or these indirect cardiac
causes?.
Reference List
1. Zarocostas J. Deaths of children under 5 fall by 27% worldwide but
maternal mortality remains same as in 1990. BMJ. 2009;338:b2136.
2. World Health Organisation. The World Health Report 2005 - Make
every mother and child count. World Health Organisation, editor. 2005.
Geneva.
3. Lewis G. Saving Mothers' Lives: reviewing maternal deaths to make
motherhood safer - 2003-2005. The Royal College of Obstetricians and
Gynaecologists, editor. 2009. London, RCOG Press.
4. Cardiopulmonary Causes of Maternal Deaths from 1994 to 2009 in the
United Kingdom. K Ogo. SV Noronha2, E Shamil3, S Lucas, MN Sheppard. Path
Soc Winter meeting 2010
Competing interests:
None declared
Competing interests:
No competing interests
01 April 2010
MARY N SHEPPARD
consultant cardiac pathologist
CRY Centre for Cardiac Pathology, Royal Brompton Hospital, SW3 6NP
what is killing these mothers?
The global maternal mortality ratio was 400 deaths per 100,000 live
births in 2005 and was almost the same as the rate in 1990. (1). As to
causes of death, about 80% of global maternal deaths are attributed to
direct causes such as haemorrhage, infections and eclampsia, whilst
indirect causes including cardiac disease are less common (2). In the UK,
in contrast, indirect causes accounted for more than half of maternal
mortality and cardiac disease became the commonest cause of maternal death
according to the latest report (2003ƒ{2005) from Confidential Enquiries
into Maternal and Child Health (CEMACH) (3). Although the maternal
mortality rate in the UK is low, 14 per 100,000, the problem is that it
has not improved in the last 20 years, in fact there has been a slight
increase. This increase is mainly due to a steady rise in maternal deaths
from cardiac disease as an indirect cause over that period. Pulmonary
embolism remains the leading direct cause, but cardiopulmonary causes now
account for one third of maternal deaths in the UK. We have recently
completed a study (4} on these cardiopulmonary cases linking them to
genetic cardiac disease and also obesity. I wonder if in USA , the causes
of maternal mortality are due to direct causes or these indirect cardiac
causes?.
Reference List
1. Zarocostas J. Deaths of children under 5 fall by 27% worldwide but
maternal mortality remains same as in 1990. BMJ. 2009;338:b2136.
2. World Health Organisation. The World Health Report 2005 - Make
every mother and child count. World Health Organisation, editor. 2005.
Geneva.
3. Lewis G. Saving Mothers' Lives: reviewing maternal deaths to make
motherhood safer - 2003-2005. The Royal College of Obstetricians and
Gynaecologists, editor. 2009. London, RCOG Press.
4. Cardiopulmonary Causes of Maternal Deaths from 1994 to 2009 in the
United Kingdom. K Ogo. SV Noronha2, E Shamil3, S Lucas, MN Sheppard. Path
Soc Winter meeting 2010
Competing interests:
None declared
Competing interests: No competing interests