Maternal deaths in Iceland over 25 years.

To access publisher's full text version of this article click on the hyperlink at the bottom of the page 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...

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Bibliographic Details
Published in:Acta Obstetricia et Gynecologica Scandinavica
Main Authors: Birgisdottir, Hera, Bjarnadottir, Ragnheidur I, Kristjansdottir, Katrin, Geirsson, Reynir T
Other Authors: 1 Univ Iceland, Fac Med, Reykjavik, Iceland, 2 Landspitali Univ Hosp, Dept Obstet & Gynecol, Womens Clin, IS-101 Reykjavik, Iceland
Format: Article in Journal/Newspaper
Language:English
Published: Wiley-Blackwell 2016
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Online Access:http://hdl.handle.net/2336/595014
https://doi.org/10.1111/aogs.12797
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Summary:To access publisher's full text version of this article click on the hyperlink at the bottom of the page 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.