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Overview of maternal mortality and morbidity

Haywood L Brown, MD
Maria J Small, MD, MPH
Section Editor
Susan M Ramin, MD
Deputy Editor
Kristen Eckler, MD, FACOG


An estimated 300,000 women died globally in 2015 as a result of pregnancy-related conditions [1]. Although maternal mortality ratios remain elevated in many areas, the maternal mortality ratio has decreased by 1.3 percent per year globally since 1990, with the greatest annualized rate of reduction in developed countries (-3.1 percent versus -1.4 percent in developing countries). During the same time period, however, the maternal mortality ratio in the United States increased [2]. Globally, reduction in maternal mortality has been attributed to reduction in the total fertility rate, increase in maternal education, and increased access to skilled birth attendants [2]. Other factors associated with maternal mortality reduction include the promotion of policies to reduce anemia and malnutrition, prevent malaria in pregnancy, provide calcium and micronutrient supplementation, encourage delivery in facilities properly resourced for emergency obstetric care, discourage early motherhood, and reduce unsafe pregnancy termination.


The International Code of Diseases (ICD-10) definitions for maternal death and its subclassifications are as follows [3,4]:

Maternal death — The death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management, but not from accidental or incidental causes [3]. Most (62 percent) maternal deaths occurred in sub-Saharan Africa (179,000 deaths) [5]. Nearly a third of maternal deaths worldwide occurred in two countries: 17 percent in India (50,000 deaths in 2013) and 14 percent in Nigeria (40,000 deaths).

Late maternal death — The death of a woman from direct or indirect obstetrical causes more than 42 days, but less than one year, after termination of pregnancy.

Pregnancy related death — Death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the cause of death. These deaths may be from accidental or incidental causes.


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