The Analysis Of Maternal Mortality In Hunan Province From2009to2011

Objective:This study is to describe the change of maternal mortality in Hunan Province from2009to2011.And to explore causes of the change, ultimately come to the conclusions that the controllable factors of decreased maternal mortality rate.Methods:The maternal mortality data and the total births were collected in the maternal and child health network in Hunan Province from2009to2011. There are572cases of maternal mortality collected according to the inclusion and exclusion criteria. Analysis of the data as follow:①describe and compare the maternal mortality rate in Hunan Province from2009to2011;②analyze the data of572cases including demographic data(age, family income, urban or rural, et al.), maternal health care (the number of pregnancy, the number of obstetrical examinations, planned or unplanned births, et al), the factors related with delivery (delivery times and location, mode of delivery, et al), the place of death, cause of death, and the conclusion of review.③569cases of maternal mortality were reliable and divided into planned births group and unplanned group, then compared the indicators between the two groups including demographic data (age, family income, urban or rural, et al.), maternal health care (the number of pregnancy, the number of obstetrical examinations, et al), the factors related with delivery (delivery times and location, mode of delivery, et al), the place of death, cause of death, and the conclusion of review.Result:①The rate of maternal mortality in Hunan Province was 27.1/100000in2009,26.7/100000in2010, and18.75/100000in2011, and the rate significantly reduced year by year (χ2=14.404, p=0.001).②the constitution of maternal mortality in annual household income are mainly low-income population from￥1000to￥4000during the3years. But the ratio of low-income population significantly reduced year by year (χ2=36.804, p=0.000). The number of maternal death in rural is more than that of urban. In rural there is significant difference of maternal mortality ratio during the3years (χ2=6.105, p=0.047), while in urban there is no difference. Avoidable deaths constitute ratio significantly increased year by year (x2=73.209, p=0.001). There is no difference of maternal mortality ratio in age, the number of pregnancy, the number of obstetrical examinations, unplanned births, delivery times and location, the mode of delivery, the place of death, causes of death.③There is significant difference of maternal mortality ratio between planned births group and unplanned group in age, in the number of pregnancy and obstetrical examinations, in delivery times and location, the mode of delivery, causes of death, and the conclusion of review. Compared with the planned births of maternal mortality group, in the unplanned births group there are more times of pregnancy and delivery, more deaths of vaginal delivery, less times of obstetrical examinations, especially the deaths who never made the obstetrical examinations significantly increased; and the unplanned childbirths more likely happened in low level hospitals, even at home or in illegal clinic; then there are more deaths from direct obstetric causes such as obstetric hemorrhage, but less deaths from indirect obstetric causes such as pregnancy with medical illness, more avoidable deaths (p<0.05). There is no difference of maternal mortality ratio in rural or urban, annual household income, location between the2groups (p>0.05). Conclusions:1. Maternal mortality rate reduced year by year in Hunan Province from2009to2011.2. The low-income people in rural had a high mortality rate of maternal. The policy of free hospital delivery for pregnant women in rural effectively reduced mortality rate of maternal, which is an important factor to decline the maternal mortality in our province during the three years.3. Avoidable deaths constitute ratio significantly increased year by year from2009to2011, which tip that we must further improve the quality of maternal health care services in our province and professional and technical level to reduce maternal mortality ratio in our province.4. The maternal deaths caused by unplanned birth is characterized by the lots of pregnancy and childbirth, old age or pregnant very young, poor maternal health care, fewer check-ups, the birth place of lower-level, the death caused by obstetric hemorrhage.