ArticleBMC pregnancy and childbirth2017
Institutional maternal and perinatal deaths: a review of 40 low and middle income countries.
Article in BMC pregnancy and childbirth, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 45 papers, 4 of them syntheses that pooled it.
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Who cites it
45 citing papers in PubMed, 4 syntheses or guidelines pooled it, 90 citations in OpenAlex.
- Timing of maternal mortality and severe morbidity during the postpartum period: a systematic review.JBI evidence synthesis · 2022Pooled it
- Obstructed labor and its effect on adverse maternal and fetal outcomes in Ethiopia: A systematic review and meta-analysis.PloS one · 2022Pooled it
- Causes of maternal mortality in Sub-Saharan Africa: A systematic review of studies published from 2015 to 2020.Journal of global health · 2021Pooled it
- Prevalence and predictors of uterine rupture among Ethiopian women: A systematic review and meta-analysis.PloS one · 2020Pooled it
- Impact of reliable light and electricity on job satisfaction among maternity health workers in Uganda: A cluster randomized trial.Human resources for health · 2022Trial
- The cost-effectiveness of using performance-based financing to deliver the basic package of health services in Afghanistan.BMJ global health · 2020Trial
- Commonest causes of maternal mortality in Nigeria: a situational report requiring an urgent action.Reproduction & fertility · 2026Review
- Prevalence and factors associated with health facility-based deliveries among urban slum settlers in Lubaga Division, Kampala District, Uganda: a community-based cross-sectional study.BMC health services research · 2026Article
- Why & where perinatal deaths: trends and determinants in Pakistan.Maternal health, neonatology and perinatology · 2026Article
- Risky fertility characteristics and determinants of pastoralist women: the case of southeastern Anatolia region.BMC women's health · 2025Article
- Maternal death surveillance in Addis Ababa, Ethiopia, 2017-2021: Causes and contributing factors.Global epidemiology · 2025Article
- Hypertensive disorders of pregnancy were more strongly associated with the functional and network profiles than with the community composition of the gut bacteriome: a pilot study.BMC pregnancy and childbirth · 2025Article
- Maternal social determinants of health: the hidden face of perinatal mortality in Mexico.International journal for equity in health · 2025Article
- Maternal Mortality: Causes, trends and delays in care at Tertiary care hospital, Pakistan.Pakistan journal of medical sciences · 2025Article
- An exploration of sub-national variability in institutional maternal mortality ratios in Kenya: a meta-analysis of the 2021 health facility data.Frontiers in global women's health · 2025Article
- Inter-facility transfers for emergency obstetrical and neonatal care in rural Madagascar: a cost-effectiveness analysis.BMJ open · 2024Article
- Incidence and determinants of perinatal mortality in five urban hospitals in Dar es Salaam, Tanzania: a cohort study with an embedded case-control analysis.BMC pregnancy and childbirth · 2024Article
- Infection-related severe maternal outcomes and case fatality rates in 43 low and middle-income countries across the WHO regions: Results from the Global Maternal Sepsis Study (GLOSS).PLOS global public health · 2024Article
- Article
- Birth asphyxia and its associated factors among newborns at a tertiary hospital: evidence from Southern Ethiopia.African health sciences · 2023Article
Corrections and comments
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Authors and funding
12 authors at 7 institutions in 3 countries.
Funding
Abstract
backgroundUnderstanding the magnitude and clinical causes of maternal and perinatal mortality are basic requirements for positive change. Facility-based information offers a contextualized resource for clinical and organizational quality improvement. We describe the magnitude of institutional maternal mortality, causes of death and cause-specific case fatality rates, as well as stillbirth and pre-discharge neonatal death rates.
methodsThis paper draws on secondary data from 40 low and middle income countries that conducted emergency obstetric and newborn care assessments over the last 10 years. We reviewed 6.5 million deliveries, surveyed in 15,411 facilities. Most of the data were extracted from reports and aggregated with excel.
resultsHemorrhage and hypertensive diseases contributed to about one third of institutional maternal deaths and indirect causes contributed another third (given the overrepresentation of sub-Saharan African countries with large proportions of indirect causes). The most lethal obstetric complication, across all regions, was ruptured uterus, followed by sepsis in Latin America and the Caribbean and sub-Saharan Africa. Stillbirth rates exceeded pre-discharge neonatal death rates in nearly all countries, possibly because women and their newborns were discharged soon after birth.
conclusionsTo a large extent, facility-based findings mirror what population-based systematic reviews have also documented. As coverage of a skilled attendant at birth increases, proportionally more deaths will occur in facilities, making improvements in record-keeping and health management information systems, especially for stillbirths and early neonatal deaths, all the more critical.
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