Maternal Mortality Risk Factors in Regional Hospital of Burkina Faso

Léon G. Blaise Savadogo, Aminata Zombra, Cécile Tamini, Maurice Kinda, Philipe Donnen

Centre Hospitalier Régional, Banfora, Burkina Faso.
CR3—Politiques et Systèmes de Santé—Santé Internationale, School of Public Health, Université Libre de Bruxelles, Bruxelles, Belgique.
Department of Epidemiology and Public Health—Child and Mother Health, Nutrition and Survival Unit—Institut Supérieur des Sciences de la Santé, Université Polytechnique, Bobo Dioulasso, Burkina Faso.
Ecole National de Santé Publique, Bobo Dioulasso, Burkina Faso.

DOI: 10.4236/ojepi.2014.42010                

Abstract

Individual causes and community determinants are synergic in maternal death occurrence. This study aimed to identify maternal mortality risk factors in a regional hospital. Material and Methods: This was a retrospective cohort study from data of 1807 hospitalized women. To identify maternal mortality risks factors, mortality hazard ratio (HR CI95%) has been calculated in univariate analysis and Cox proportional hazard model. Results: During hospitalization, 30 maternal deaths occurred. From Cox regression, adjusted mortality HR confirmed that women age older than 35 (HR = 2.5, CI95%: [1.2-5.7] and younger than 19 (HR = 3.02, CI95%: [1.5-6.7]); distance to hospital ≥10 Km (HR = 4.1, CI95%: [1.8-9.4]; multiple deliveries (HR = 2.4, CI95%: [1.1-7.3]), less ante natal care (<3 visits) (HR = 3.03, CI95%: [0.97-9.48]); obstetrical maternal mortality directs causes (HR = 2.31, CI95%: [1.7-6.21]) and emergently reference (HR = 3.5, CI95%: [1.8-8.32]) were maternal mortality risk factors. Conclusion: In this regional hospital of low income country, identified maternal mortality factors are related to women socio-economic determinants and quality prenatal or obstetric care access. Interventions to reduce maternal mortality rate should be conducted within both household and women socio-economic status development and in maternal health and obstetric care strengthening.

Keywords

Maternal Mortality; Risk Factors; Regional Hospital; Burkina Faso

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	WHO (2012) Trends in Maternal Mortality: 1990 to 2010. WHO, UNICEF, UNFPA and The World Bank estimates. WHO.
[2]	Paxton, A. and Wardlaw, T. (2011) Are We Making Progress in Maternal Mortality? The New England Journal of Medicine, 364, 1990-1993. http://dx.doi.org/10.1056/NEJMp1012860
[3]	Fawole, A.O., Shah, A., Fabanwo, A.O., Adegbola, O., Adewunmi, A.A., Eniayewun, A.B., Dara, K., El-Ladan, A.M., Umezulike, A.C., Alu, F.E., Adebayo, A.A., Obaitan, F.O., Onala, O.E., Usman, Y., Sullayman, A.O., Kailani, S. and Sa’id, M. (2012) Predictors of Maternal Mortality in Institutional Deliveries in Nigeria. African Health Sciences, 12, 32-40.
[4]	Nabukalu, D., Klipstein-Grobusch, K., Herbst, K. and Newell, M-L. (2013) Mortality in Women of Reproductive age in Rural South Africa. Glob Health Action, 6, Article ID: 22834. http://dx.doi.org/10.3402/gha.v6i0.22834
[5]	De Moraes, A.P.P., Barreto, S.M., Passos, V.M.A., Golino, P.S., Costa, J.E. and Vasconcelos, M.X. (2013) Severe Maternal Morbidity: A Casecontrol Study in Maranhao, Brazil. Reproductive Health, 10, 11. http://dx.doi.org/10.1186/1742-4755-10-11
[6]	Illah, E., Mbaruku, G., Masanja, H. and Kahn, K. (2013) Causes and Risk Factors for Maternal Mortality in Rural Tanzania—Case of Rufiji Health and Demographic Surveillance Site (HDSS). African Journal of Reproductive Health, 17, 119-130.
[7]	Saleh, W.F., Ragab, W.S. and Aboulgheit, S.S. (2013) Audit of Maternal Mortality Ratio and Causes of Maternal Deaths in the Largest Maternity Hospital in Cairo, Egypt (Kasr Al Aini) in 2008 and 2009: Lessons Learned. African Journal of Reproductive Health, 17, 105-109.
[8]	Garba, M., Nayama, M., Alio, A.P., Holloway, M.L., Hamisu, B.S. and Salihu, H.M. (2011) Maternal Mortality in Niger: A Retrospective Study in a High Risk Maternity. African Journal of Medicine & Medical Sciences, 40, 393-397.
[9]	Kane, T.T., El-Kady, A.A., Saleh, S., Hage, M., Stanback, J. and Potter, L. (1992) Maternal Mortality in Giza, Egypt: Magnitude, Causes, and Prevention. Studies in Family Planning, 23, 45-57. http://dx.doi.org/10.2307/1966827
[10]	Alauddin, M. (1986) Maternal Mortality in Rural Bangladesh: The Tangail District. Studies in Family Planning, 17, 13-21. http://dx.doi.org/10.2307/1966951
[11]	Walker, G., Affette, J.A., Mccaw, M., Ashley, D.E.C. and Bernard, G.W. (1986) Maternal Mortality in Jamaica. The Lancet, 327, 486-488. http://dx.doi.org/10.1016/S0140-6736(86)92939-9
[12]	Chowdhury, M., Botlero, E.R., Koblinsky, M., Saha, S.K., Dieltiens, G. and Ronsmans, C. (2007) Determinants of Reduction in Maternal Mortality in Matlab, Bangladesh: A 30 Year Cohort Study. The Lancet, 370, 1320-1328. http://dx.doi.org/10.1016/S0140-6736(07)61573-6
[13]	Bonzini, M., Coggon, D. and Palmer, K. (2007) Risk of Prematurity, Low Birth Weight and Preeclamsia in Relation to Working Hours and Physical Activities: A Systematic Review. Journal of Occupational and Environmental Medicine, 64, 228-243. http://dx.doi.org/10.1136/oem.2006.026872
[14]	Mozurkewich, E.L., Luke, B. and Avni, M. (2000) Working Conditions and Adverse Pregnancy Outcome: A Meta-Analysis. Obstetrics and Gynecology, 95, 623-635. http://dx.doi.org/10.1016/S0029-7844(99)00598-0
[15]	Jayachandran, S. and Lleras-Muney, A. (2009) Life Expectancy and Human Capital Investments: Evidence from Maternal Mortality Declines. Quarterly Journal of Economics, 124, 349-397. http://dx.doi.org/10.1162/qjec.2009.124.1.349
[16]	Okonofua, F.E., Abejide, A. and Makanjuola, R.A. (1992) Maternal Mortality in Ile-Ife, Nigeria: A Study of Risk factors. Studies in Family Planning, 23, 319-324. http://dx.doi.org/10.2307/1966529
[17]	Maine, D., Akalin, M.Z., Chakraborty, J., Francisco, A. and Strong, M. (1996) Why Did Maternal Mortality Decline in Matlab? Studies in Family Planning, 27, 179-187. http://dx.doi.org/10.2307/2137952
[18]	Granja, A.C., Machungo, F., Gomes, A., Bergstrom, S. and Brabin, B. (1998) Malaria Related Maternal Mortality in Urban Mozambique. Annals of Tropical Medicine and Parasitology, 92, 257-263. http://dx.doi.org/10.1080/00034989859816
[19]	Ahmed, Y.P., Mwaba, C., Chintu, J.M., Grange, A., Ustianowski, A. and Zumla, N. (1999) A Study of Maternal Mortality at the University Teaching Hospital, Lusaka, Zambia: The Emergence of Tuberculosis as a Major Non-Obstetric Cause of Maternal Death. International Journal of Tuberculosis and Lung Disease, 3, 675-680.
[20]	Khan, M., Pillay, T., Moodley, J.M. and Connolly, C.A. (2001) Maternal Mortality Associated with Tuberculosis-HIV-1 Co-Infection in Durban, South Africa. Aids, 15, 1857-1863. http://dx.doi.org/10.1097/00002030-200109280-00016