SynthesisThe Lancet. Global health2014
Global causes of maternal death: a WHO systematic analysis.
Synthesis in The Lancet. Global health, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 25 registered trials, which are not on this map. Cited by 2,679 papers, 14 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Integrating Services for Noncommunicable Diseases in Continuum of Care for Mothers and Children: a Cluster Randomized Control Trial in Myanmar
Prevention of Postpartum Hemorrhage With Tranexamic Acid (TXA)
A Clinical Study to Define Precision, Accuracy, and Comparability of Results From a Novel Point of Care Fibrinogen Assay (F-Point), Compared to an Industry Standard
Use of Tranexamic Acid for Prevention of Hemorrhage in Cesarean Delivery
The Pharmacokinetics of Oxytocin in Pregnant Women Undergoing Cesarean Delivery - a Feasibility Pilot Study
Non-Invasive Hemorrhage Monitoring: A Pilot Study to Assess the Feasibility and Tolerability of the AccuFlow Perfusion Sensor for the Detection of Intrapartum Hemorrhage
Remote Biomonitoring for Temperature Surveillance of Mothers and Newborns: Pre-clinical and Clinical Evaluation
Validation of the Quick Sequential [Sepsis-related] Organ Failure Assessment (qSOFA) Predictive Model in the Prediction of Severe Infection - Sepsis in Obstetric Patients and Adverse Neonatal Outcomes: a Multicenter Study
A Prospective Muti-center Study of Early Prediction and Randomised Prevention of Preeclampsia With Low Dose Aspirin in Chinese Cohort
Addressing Provider Stress and Unconscious Bias to Improve Quality of Maternal Health Care
Retrospective Assessment of the Risk of Peripartum Hemorrhage in Pregnant Women : Retrospective Assessment of the Diagnostic Performance of the HEMSTOP Standardized Questionnaire
Randomized Double-Blinded Clinical Trial of Oxytocin Bolus Versus Infusion in Elective Cesarean Section
Incidence and Risk Factors of Postpartum Hemorrhage at the Brugmann University Hospital in Comparison to the Literature
Prevention of Iron Deficiency Anemia Post-delivery (PRIORITY Trial): A Randomized Controlled Trial of the Global Network for Women's and Children's Health Research
Caffeine in the Second Stage: A Randomized Control Trial in Low-risk Nulliparous Mothers at Term
Evaluation of Coagulation Status of Pregnant Women in the Peripartum Period Using the Device Clotpro®, a Prospective Observational Study
Caring for Providers to Improve Patient Experience (CPIPE) Study: A Cluster Randomized-controlled Trial to Assess the Impact of the CPIPE Intervention on Person-centered Maternity Care
Uterine Preservation With Acar's Atony Suture for Postpartum Uterine Atony
Clinical Trial Designed to Assess the Safety and Effectiveness of the KOKO™ Device In Treating Primary Abnormal Postpartum Uterine Bleeding ("APUB") or Hemorrhage ("PPH")
Early Factor XIII Replacement in Postpartum Hemorrhage: Multi-center, Randomized, Controlled, Investigator-initiated Trial
Uro-catheter Vacuum-induced Uterine Tamponade (U-CaVIT) Versus Standard of Care for Prevention of Atonic Postpartum Hemorrhage After Cesarean Section in High-risk Women: a Monocentric Randomized-controlled Pilot Study.
Development and Validation of an Obstetric Organ Dysfunction Score to Predict Mortality in Intensive Care Unit: A Multicenter, Prospective, Cohort Study
Mobile-based Obstetric Monitoring for Pregnancies Complicated by Hypertension and/or Diabetes (MOM-HD): a Type II Hybrid Implementation-Effectiveness Trial
Multicenter Randomized Trial of an sFlt-1/PlGF Ratio-Based Algorithm for Timing of Delivery in Early-Onset Severe Preeclampsia: The MAP 2 Study
Randomized Double-Blinded Clinical Trial of Oxytocin Bolus Versus Infusion in High-Risk Patients Undergoing Elective Cesarean Section
Who cites it
2,679 citing papers in PubMed, 14 syntheses or guidelines pooled it.
- Intrauterine balloon tamponade versus uterine gauze packing for postpartum hemorrhage: A systematic review and meta-analysis.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2026Pooled it
- Diagnostic accuracy of NLR, MLR, PLR, SII, and SIRI for predicting major adverse maternal outcomes in preeclampsia: A systematic review.The Journal of international medical research · 2026Pooled it
- Eclampsia Incidence, Management and Outcomes Across Multi-Country Surveillance Cohorts: Individual Participant Data Meta-Analysis.BJOG : an international journal of obstetrics and gynaecology · 2026Pooled it
- Experiences and self-reported outcomes of abortion care in Sub-Saharan countries: a mixed methods systematic review.Journal of health, population, and nutrition · 2026Pooled it
- Feasibility, acceptability and effectiveness of group antenatal care on maternal health continuum of care and perinatal outcomes in sub-Saharan Africa: a systematic review and meta-analysis.BMJ global health · 2026Pooled it
- Model Development on Adherence to Aspirin in Pregnancy: A Co-Produced Qualitative Systematic Review and Meta-Ethnography.Health expectations : an international journal of public participation in health care and health policy · 2026Pooled it
- Factors influencing implementation of point-of-care tests for maternal and newborn screening and diagnosis in low-resource settings: a systematic review.BMC global and public health · 2026Pooled it
- Preeclampsia Genomic Susceptibility Factors in Populations of African Ancestry: A Systematic Review and Meta-Analysis.International journal of molecular sciences · 2026Pooled it
- Sociocultural and health system determinants of maternal mortality in Ghana: findings from a systematic review.BMC public health · 2026Pooled it
- Estimating Causal Effects of Third-Stage Management on Postpartum Haemorrhage in a Midwifery Context: An Evidence Synthesis Approach for Constructing Directed Acyclic Graphs.Paediatric and perinatal epidemiology · 2026Pooled it
- Hypertensive disorders of pregnancy in low- and middle-income countries: a review of antenatal interventions to improve maternal outcomes.Frontiers in global women's health · 2026Pooled it
- Cardiac and Obstetric Complications of Pregnant Women with Rheumatic Heart Disease in Sub-Saharan Africa: A Systematic Review.Global heart · 2026Pooled it
- Objective monitoring of postpartum uterine activity: a systematic scoping review.Frontiers in medicine · 2026Pooled it
- Socioeconomic and health system determinants of maternal health inequities across Chinese provinces (2009-2021): a multivariate meta-regression analysis of regional heterogeneity in underlying mechanisms.Frontiers in public health · 2026Pooled it
- Feasibility of multi-component intervention for blood pressure control in pregnancy in Nigeria and Ghana: a pilot randomized clinical trial.BMC pregnancy and childbirth · 2026Trial
- Intrapartum oral azithromycin for maternal infection prophylaxis and the risk of postpartum hemorrhage: A secondary analysis of the A-PLUS trial.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2026Trial
- Postpartum readmission for maternal infection or neonatal adverse events in women randomised to outpatient balloon versus inpatient prostaglandin for induction of labour: a post-trial follow up study.BMC pregnancy and childbirth · 2026Trial
- Intramyometrial injection versus intravenous infusion of oxytocin for maintaining uterine contractility during elective caesarean delivery in a randomised controlled trial.Scientific reports · 2026Trial
- Trial
- Integrating behavioural science and design thinking to develop a water treatment innovation in Malawi healthcare: a case study of the intervention design process.Global health action · 2026Article
2,619 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
9 authors.
Funding
Abstract
backgroundData for the causes of maternal deaths are needed to inform policies to improve maternal health. We developed and analysed global, regional, and subregional estimates of the causes of maternal death during 2003-09, with a novel method, updating the previous WHO systematic review.
methodsWe searched specialised and general bibliographic databases for articles published between between Jan 1, 2003, and Dec 31, 2012, for research data, with no language restrictions, and the WHO mortality database for vital registration data. On the basis of prespecified inclusion criteria, we analysed causes of maternal death from datasets. We aggregated country level estimates to report estimates of causes of death by Millennium Development Goal regions and worldwide, for main and subcauses of death categories with a Bayesian hierarchical model.
findingsWe identified 23 eligible studies (published 2003-12). We included 417 datasets from 115 countries comprising 60 799 deaths in the analysis. About 73% (1 771 000 of 2 443 000) of all maternal deaths between 2003 and 2009 were due to direct obstetric causes and deaths due to indirect causes accounted for 27·5% (672 000, 95% UI 19·7-37·5) of all deaths. Haemorrhage accounted for 27·1% (661 000, 19·9-36·2), hypertensive disorders 14·0% (343 000, 11·1-17·4), and sepsis 10·7% (261 000, 5·9-18·6) of maternal deaths. The rest of deaths were due to abortion (7·9% [193 000], 4·7-13·2), embolism (3·2% [78 000], 1·8-5·5), and all other direct causes of death (9·6% [235 000], 6·5-14·3). Regional estimates varied substantially.
interpretationBetween 2003 and 2009, haemorrhage, hypertensive disorders, and sepsis were responsible for more than half of maternal deaths worldwide. More than a quarter of deaths were attributable to indirect causes. These analyses should inform the prioritisation of health policies, programmes, and funding to reduce maternal deaths at regional and global levels. Further efforts are needed to improve the availability and quality of data related to maternal mortality.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.