Global, regional, and national levels and causes of maternal mortality during 1990-2013 : a systematic analysis for the Global Burden of Disease Study 2013

Kassebaum, Nicholas J. and Bertozzi-Villa, Amelia and Coggeshall, Megan S. and Shackelford, Katya A. and Steiner, Caitlyn and Heuton, Kyle R. and Gonzalez-Medina, Diego and Barber, Ryan and Huynh, Chantal and Dicker, Daniel and Templin, Tara and Wolock, Timothy M. and Ozgoren, Ayse Abbasoglu and Abd-Allah, Foad and Abera, Semaw Ferede and Abubakar, Ibrahim and Achoki, Tom and Adelekan, Ademola and Ademi, Zanfina and Adou, Arsène Kouablan and Adsuar, José C. and Agardh, Emilie E. and Akena, Dickens and Alasfoor, Deena and Alemu, Zewdie Aderaw and Alfonso-Cristancho, Rafael and Alhabib, Samia and Ali, Raghib and Al Kahbouri, Mazin J. and Alla, François and Allen, Peter J. and AlMazroa, Mohammad A. and Alsharif, Ubai and Alvarez, Elena and Alvis-Guzmán, Nelson and Amankwaa, Adansi A. and Amare, Azmeraw T. and Amini, Hassan and Ammar, Walid and Antonio, Carl A. T. and Anwari, Palwasha and Arnlöv, Johan and Arsenijevic, Valentina S. Arsic and Artaman, Ali and Asad, Majed Masoud and Asghar, Rana J. and Assadi, Reza and Atkins, Lydia S. and Badawi, Alaa and Balakrishnan, Kalpana and Basu, Arindam and Basu, Sanjay and Beardsley, Justin and Bedi, Neeraj and Bekele, Tolesa and Bell, Michelle L. and Bernabe, Eduardo and Beyene, Tariku J. and Bhutta, Zulfiqar and Bin Abdulhak, Aref and Blore, Jed D. and Basara, Berrak Bora and Bose, Dipan and Breitborde, Nicholas and Cárdenas, Rosario and Castañeda-Orjuela, Carlos A. and Castro, Ruben Estanislao and Catalá-López, Ferrán and Cavlin, Alanur and Chang, Jung-Chen and Che, Xuan and Christophi, Costas A. and Chugh, Sumeet S. and Cirillo, Massimo and Colquhoun, Samantha M. and Cooper, Leslie Trumbull and Cooper, Cyrus and da Costa Leite, Iuri and Dandona, Lalit and Dandona, Rakhi and Davis, Adrian and Dayama, Anand and Degenhardt, Louisa and De Leo, Diego and del Pozo-Cruz, Borja and Deribe, Kebede and Dessalegn, Muluken and deVeber, Gabrielle A. and Dharmaratne, Samath D. and Dilmen, Uğur and Ding, Eric L. and Dorrington, Rob E. and Driscoll, Tim R. and Ermakov, Sergei Petrovich and Esteghamati, Alireza and Faraon, Emerito Jose A. and Farzadfar, Farshad and Felicio, Manuela Mendonca and Fereshtehnejad, Seyed-Mohammad and de Lima, Graça Maria Ferreira and Forouzanfar, Mohammad H. and França, Elisabeth B. and Gaffikin, Lynne and Gambashidze, Ketevan and Gankpé, Fortuné Gbètoho and Garcia, Ana C. and Geleijnse, Johanna M. and Gibney, Katherine B. and Giroud, Maurice and Glaser, Elizabeth L. and Goginashvili, Ketevan and Gona, Philimon and González-Castell, Dinorah and Goto, Atsushi and Gouda, Hebe N. and Gugnani, Harish Chander and Gupta, Rahul and Gupta, Rajeev and Hafezi-Nejad, Nima and Hamadeh, Randah Ribhi and Hammami, Mouhanad and Hankey, Graeme J. and Harb, Hilda L. and Havmoeller, Rasmus and Hay, Simon I. and Pi, Ileana B. Heredia and Hoek, Hans W. and Hosgood, H. Dean and Hoy, Damian G. and Husseini, Abdullatif and Idrisov, Bulat T. and Innos, Kaire and Inoue, Manami and Jacobsen, Kathryn H. and Jahangir, Eiman and Jee, Sun Ha and Jensen, Paul N. and Jha, Vivekanand and Jiang, Guohong and Jonas, Jost B. and Juel, Knud and Kabagambe, Edmond Kato and Kan, Haidong and Karam, Nadim E. and Karch, André and Karema, Corine Kakizi and Kaul, Anil and Kawakami, Norito and Kazanjan, Konstantin and Kazi, Dhruv S. and Kemp, Andrew H. and Kengne, Andre Pascal and Kereselidze, Maia and Khader, Yousef Saleh and Khalifa, Shams Eldin Ali Hassan and Khan, Ejaz Ahmed and Khang, Young-Ho and Knibbs, Luke and Kokubo, Yoshihiro and Kosen, Soewarta and Defo, Barthelemy Kuate and Kulkarni, Chanda and Kulkarni, Veena S. and Kumar, G. Anil and Kumar, Kaushalendra and Kumar, Ravi B. and Kwan, Gene and Lai, Taavi and Lalloo, Ratilal and Lam, Hilton and Lansingh, Van C. and Larsson, Anders and Lee, Jong-Tae and Leigh, James and Leinsalu, Mall and Leung, Ricky and Li, Xiaohong and Li, Yichong and Li, Yongmei and Liang, Juan and Liang, Xiaofeng and Lim, Stephen S. and Lin, Hsien-Ho and Lipshultz, Steven E. and Liu, Shiwei and Liu, Yang and Lloyd, Belinda K. and London, Stephanie J. and Lotufo, Paulo A. and Ma, Jixiang and Ma, Stefan and Machado, Vasco Manuel Pedro and Mainoo, Nana Kwaku and Majdan, Marek and Mapoma, Christopher Chabila and Marcenes, Wagner and Marzan, Melvin Barrientos and Mason-Jones, Amanda J. and Mehndiratta, Man Mohan and Mejia-Rodriguez, Fabiola and Memish, Ziad A. and Mendoza, Walter and Miller, Ted R. and Mills, Edward J. and Mokdad, Ali H. and Mola, Glen Liddell and Monasta, Lorenzo and de la Cruz Monis, Jonathan and Hernandez, Julio Cesar Montañez and Moore, Ami R. and Moradi-Lakeh, Maziar and Mori, Rintaro and Mueller, Ulrich O. and Mukaigawara, Mitsuru and Naheed, Aliya and Naidoo, Kovin S. and Nand, Devina and Nangia, Vinay and Nash, Denis and Nejjari, Chakib and Nelson, Robert G. and Neupane, Sudan Prasad and Newton, Charles R. and Ng, Marie and Nieuwenhuijsen, Mark J. and Nisar, Muhammad Imran and Nolte, Sandra and Norheim, Ole F. and Nyakarahuka, Luke and Oh, In-Hwan and Ohkubo, Takayoshi and Olusanya, Bolajoko O. and Omer, Saad B. and Opio, John Nelson and Orisakwe, Orish Ebere and Pandian, Jeyaraj D. and Papachristou, Christina and Park, Jae-Hyun and Caicedo, Angel J. Paternina and Patten, Scott B. and Paul, Vinod K. and Pavlin, Boris Igor and Pearce, Neil and Pereira, David M. and Pesudovs, Konrad and Petzold, Max and Poenaru, Dan and Polanczyk, Guilherme V. and Polinder, Suzanne and Pope, Dan and Pourmalek, Farshad and Qato, Dima and Quistberg, D. Alex and Rafay, Anwar and Rahimi, Kazem and Rahimi-Movaghar, Vafa and ur Rahman, Sajjad and Raju, Murugesan and Rana, Saleem M. and Refaat, Amany and Ronfani, Luca and Roy, Nobhojit and Pimienta, Tania Georgina Sánchez and Sahraian, Mohammad Ali and Salomon, Joshua A. and Sampson, Uchechukwu and Santos, Itamar S. and Sawhney, Monika and Sayinzoga, Felix and Schneider, Ione J. C. and Schumacher, Austin and Schwebel, David C. and Seedat, Soraya and Sepanlou, Sadaf G. and Servan-Mori, Edson E. and Shakh-Nazarova, Marina and Sheikhbahaei, Sara and Shibuya, Kenji and Shin, Hwashin Hyun and Shiue, Ivy and Sigfusdottir, Inga Dora and Silberberg, Donald H. and Silva, Andrea P. and Singh, Jasvinder A. and Skirbekk, Vegard and Sliwa, Karen and Soshnikov, Sergey S. and Sposato, Luciano A. and Sreeramareddy, Chandrashekhar T. and Stroumpoulis, Konstantinos and Sturua, Lela and Sykes, Bryan L. and Tabb, Karen M. and Talongwa, Roberto Tchio and Tan, Feng and Teixeira, Carolina Maria and Tenkorang, Eric Yeboah and Terkawi, Abdullah Sulieman and Thorne-Lyman, Andrew L. and Tirschwell, David L. and Towbin, Jeffrey A. and Tran, Bach X. and Tsilimbaris, Miltiadis and Uchendu, Uche S. and Ukwaja, Kingsley N. and Undurraga, Eduardo A. and Uzun, Selen Begüm and Vallely, Andrew J. and van Gool, Coen H. and Vasankari, Tommi J. and Vavilala, Monica S. and Venketasubramanian, N. and Villalpando, Salvador and Violante, Francesco S. and Vlassov, Vasiliy Victorovich and Vos, Theo and Waller, Stephen and Wang, Haidong and Wang, Linhong and Wang, XiaoRong and Wang, Yanping and Weichenthal, Scott and Weiderpass, Elisabete and Weintraub, Robert G. and Westerman, Ronny and Wilkinson, James D. and Woldeyohannes, Solomon Meseret and Wong, John Q. and Wordofa, Muluemebet Abera and Xu, Gelin and Yang, Yang C. and Yano, Yuichiro and Yentur, Gokalp Kadri and Yip, Paul and Yonemoto, Naohiro and Yoon, Seok-Jun and Younis, Mustafa Z. and Yu, Chuanhua and Jin, Kim Yun and El Sayed Zaki, Maysaa and Zhao, Yong and Zheng, Yingfeng and Zhou, Maigeng and Zhu, Jun and Zou, Xiao Nong and Lopez, Alan D. and Naghavi, Mohsen and Murray, Christopher J. L. and Lozano, Rafael. (2014) Global, regional, and national levels and causes of maternal mortality during 1990-2013 : a systematic analysis for the Global Burden of Disease Study 2013. Lancet, 384 (9947). pp. 980-1004.

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Official URL: http://edoc.unibas.ch/50722/

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The fifth Millennium Development Goal (MDG 5) established the goal of a 75% reduction in the maternal mortality ratio (MMR; number of maternal deaths per 100,000 livebirths) between 1990 and 2015. We aimed to measure levels and track trends in maternal mortality, the key causes contributing to maternal death, and timing of maternal death with respect to delivery.; We used robust statistical methods including the Cause of Death Ensemble model (CODEm) to analyse a database of data for 7065 site-years and estimate the number of maternal deaths from all causes in 188 countries between 1990 and 2013. We estimated the number of pregnancy-related deaths caused by HIV on the basis of a systematic review of the relative risk of dying during pregnancy for HIV-positive women compared with HIV-negative women. We also estimated the fraction of these deaths aggravated by pregnancy on the basis of a systematic review. To estimate the numbers of maternal deaths due to nine different causes, we identified 61 sources from a systematic review and 943 site-years of vital registration data. We also did a systematic review of reports about the timing of maternal death, identifying 142 sources to use in our analysis. We developed estimates for each country for 1990-2013 using Bayesian meta-regression. We estimated 95% uncertainty intervals (UIs) for all values.; 292,982 (95% UI 261,017-327,792) maternal deaths occurred in 2013, compared with 376,034 (343,483-407,574) in 1990. The global annual rate of change in the MMR was -0·3% (-1·1 to 0·6) from 1990 to 2003, and -2·7% (-3·9 to -1·5) from 2003 to 2013, with evidence of continued acceleration. MMRs reduced consistently in south, east, and southeast Asia between 1990 and 2013, but maternal deaths increased in much of sub-Saharan Africa during the 1990s. 2070 (1290-2866) maternal deaths were related to HIV in 2013, 0·4% (0·2-0·6) of the global total. MMR was highest in the oldest age groups in both 1990 and 2013. In 2013, most deaths occurred intrapartum or postpartum. Causes varied by region and between 1990 and 2013. We recorded substantial variation in the MMR by country in 2013, from 956·8 (685·1-1262·8) in South Sudan to 2·4 (1·6-3·6) in Iceland.; Global rates of change suggest that only 16 countries will achieve the MDG 5 target by 2015. Accelerated reductions since the Millennium Declaration in 2000 coincide with increased development assistance for maternal, newborn, and child health. Setting of targets and associated interventions for after 2015 will need careful consideration of regions that are making slow progress, such as west and central Africa.; Bill & Melinda Gates Foundation.
Faculties and Departments:09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH)
UniBasel Contributors:Amini, Hassan
Item Type:Article, refereed
Article Subtype:Research Article
Note:Publication type according to Uni Basel Research Database: Journal article
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Last Modified:06 Mar 2017 07:53
Deposited On:06 Mar 2017 07:53

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