Maternal Mortality Rate in Fars Province: Trends and Associated Factors in a Community-Based Survey

Background: The high rate of maternal mortality (MM) remains a challenge, especially in developing countries. In 2000, the World Health Organization (WHO) targeted a 75% reduction by the end of 2015. In this survey, we determine trends in MM rates and associated factors in Fars Province, southwestern Iran. Methods: All MM in Fars Province from March 2003 to March 2010 were considered in this cross-sectional study. Data were recorded for demographic characteristics, autopsy findings, medical and obstetric histories. The data were then analyzed with a z-test to identify differences in the rate of MM during the study period. Results: The mean MM rate was 22.18 per 100 000 live births (95% CI, 17.55-26.8) during the seven year study period, and was highest (32.3/100 000) in the first year. Most deaths (71.3%) occurred in the postpartum period, and the lowest proportion occurred during delivery (5%). High-risk mothers accounted for 79.2% of maternal deaths. Among the mothers who died, 62% received satisfactory prenatal care, and at least two years elapsed between successive pregnancies in 78%. Hemorrhage was the main cause of death (35.6%) and the least frequent cause was H1N1 virus infection (2%). Conclusion: This study provides evidence of serious deficiencies in postpartum care that need urgent action. Priority should be given to vaginal bleeding and high-risk status mothers.