Causes of maternal mortality in Lagos State, Nigeria

Background: Maternal mortality remains a major problem in many parts of the world including Nigeria. Understanding the causes of maternal mortality is crucial in confronting the challenge of unyielding high rates. The aim of this study was to determine the direct and indirect causes of maternal mortality in Lagos State, Nigeria. Materials and Methods: The study is a descriptive cross-sectional survey. The study population consisted of adults residing in Lagos State, Nigeria. The sample size used for this study was 29,988. The respondents were selected by multistage sampling from all the local government areas in the state. Data were collected using a structured interviewer-administered questionnaire. Data entry, cleaning, validation and analysis were done using Statistical Package for Social Sciences version 15.0. Results: Among the 29,988 respondents, 306 (1.0%) gave a history of married sisters who died during pregnancy, childbirth or during the postpartum period. Of the 306, 138 (45.1%) died during pregnancy; 107 (34.9%) died during childbirth, and 61 (19.9%) died during the postpartum period. Abortion, ectopic pregnancies and hypertension were the most commonly mentioned cause of death during pregnancy, while anemia, prolonged labor and obstructed labor were the common causes during childbirth. Human immunodeficiency virus/acquired immunodeficiency syndrome, infection and malaria were the common causes of maternal death during the 6 weeks after end of pregnancy/childbirth. Conclusions and Recommendation: Over half of the maternal deaths in Lagos State occurred during labor and immediately postpartum. Community education on the importance of having skilled attendants at delivery must be provided. Emergency obstetric care should be available, accessible and affordable at health facilities, and efforts must be made to prevent unwanted pregnancies and unsafe abortions by increasing contraceptive use. The malaria control efforts should be intensified.