A twenty year profile of maternal mortality trends in Nagpur City, 1957-76
Rao, G.R.; Shastrakar, V.D.; Gupta, B.P.
Journal of Obstetrics and Gynaecology of India 33(2): 201-208
1983
ISSN/ISBN: 0971-9202 PMID: 12315508 Document Number: 575578
Between 1957 and 1976 maternal mortality in the city of Nagpur declined from 9.2/1000 live births to 1.9/1000 live births. Nagpur is a city of 225 sq km with a 1976 population of 1 million. Deaths were considered maternally related if they were a result of any of the conditions listed in Section XI of the International Classification of Diseases. During the 20 years studied, there were 2344 maternal deaths in Nagpur. Rates were calculated separately for residential and hospital deaths, and hospital deaths were found to be close to the total maternal mortality rates. Although maternal deaths, as a proportion of female deaths per 1000, declined from 28.5 to 16.4, 1 in 7 female deaths is still maternity-related. During the 1st 5-year period maternal deaths by major specific causes were toxemias (22.7%), sepsis (20.3%), anemia (19.1%), hemorrhage (9.2%), and abortion (2.8%). By the 4th 5-year period, toxemias had dropped to 13.8% and anemia to 6.6%, but sepsis had risen to 29.8% and fatal abortion to 17.7%. The increase in percent of deaths from sepsis was caused by the development of drug-resistant strains of bacteria in hospitals. The increase in percent of fatal abortion is probably due to the increase in the proportion of deaths in the over-45 age group. In the 1st decade maternal mortality in the over-45 age group was only 8 times greater than that of the under-20 group, but by the end of the 2nd decade, the ratio had increased to 22:1, a ratio similar to that in developed countries. In terms of absolute numbers maternal deaths from all causes declined over the 20-year period.