Maternal deaths in Australia 2000-2002
Summary
There were 95 maternal deaths in the triennia 2000–2002. Of these, 8 were late maternal deaths (occurring up to one year after the end of the pregnancy) and three were incidental deaths (believed to be unrelated to pregnancy).
The Maternal Mortality Ratio (MMR), based on direct and indirect deaths was 11.1 deaths per 100,000 women who gave birth. This was higher than MMR of 8.4 deaths per 100, 000 women who gave birth for the previous triennia 1997–1999. The higher MMR is associated with an increase in the number of deaths indirectly related to pregnancy or its management from 30 in 1997–1999 to 52 in 2000–2002. This rise is primarily the result of improved reporting of deaths, and changes in the classification of some deaths from incidental to indirect. The number of incidental deaths fell from 28 in 1997-1999 to 3 over the same period.
Direct maternal deaths result from the obstetric complications of pregnancy. The most common causes of the 32 direct maternal deaths were amniotic fluid embolism (10; 31.2%), obstetric haemorrhage (9; 28.1%), infection (5; 15.6%) and hypertensive disorders of pregnancy (4; 12.5%).
The maternal mortality ratio for direct deaths was 4.2 per 100,000 women who gave birth compared to 4.5 per 100,000 women who gave birth during 1997-1999.
There was a decline in direct maternal deaths from pulmonary thromboembolism from 8 in 1994-1996 to 6 in 1997-1999 to 2 in 2000-2002. Pulmonary thromboembolism was a contributory cause of death in three additional deaths with a principal cause of infection.
There were 11 maternal deaths of Aboriginal women and 2 of Torres Strait Islander women. Twelve of these deaths were related to pregnancy with one maternal death per 2,177 Aboriginal or Torres Strait Islander women who gave birth. The maternal mortality ratio for Aboriginal and Torres Strait Islander women for the six year period 1997-2002 was 34.8 deaths per 100,000 women who gave birth – a rate 4.5 times that of non-Indigenous Australian women (MMR of 7.7 deaths per 100,000 women who gave birth) who gave birth.
The age of women who died ranged from 17 to 50 years including 4 (4.8%) teenagers. The MMR was highest for women aged 40-50 years (32.8 per 100,000 women gave birth) compared to women aged 20-24 years (4.3 per 100,000 women who gave birth). There were three cases where caesarean section was thought to be a contributory cause of death. The number of deaths associated with anaesthesia declined from 3 in 1997-1999 to 1 in 2000-2002.
Indirect maternal deaths result from pre-existing disease which maybe aggravated by the physiological effects of pregnancy. The most common causes of the 52 indirect deaths were cardiac disease (11; 21.1%), infection (10; 19.2%) psychiatric causes (9; 17.3%) and other haemorrhage (8; 15.4%). Five of the seven deaths due to suicide were to women who were less than 20 weeks gestation.
There was a decline in deaths from motor vehicle accidents from 5 in 1997-1999 to 1 in the 2000–2002 triennium.