Archives of the Balkan Medical Union (Sep 2021)

The evolution of maternal mortality in Romania in the last decade, trends and challenges

  • Calin POPOVICI,
  • Petru ARMEAN,
  • Andrei KOZMA

DOI
https://doi.org/10.31688/ABMU.2021.56.3.08
Journal volume & issue
Vol. 56, no. 3
pp. 342 – 348

Abstract

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Introduction. In Romania, the number of cases of maternal death has decreased significantly in recent years. Material and methods. The objective of this review is to assess maternal mortality in Romania in the last decade (2010-2019) in terms of the evolution of the number of cases and socio-demographic characteristics, by death groups and the identification of predictors of severe obstetric morbidity. Results. The number of maternal deaths decreased during the analyzed period by almost 60% (from 51 deaths in 2010 to 20 in 2019). We observed the decrease of maternal death index from 24.0/100,000 live births in 2010 to 10.6/100,000 live births in 2019. Considering maternal death groups, the result is mainly due to the decrease of abortion and indirect obstetrical risk, maintaining the trend of a higher mortality through direct obstetrical risk. Maternal deaths and mortality as a whole also decreased in terms of distribution by area for this period, generally maintaining the gap in favor of the rural environment. A number of factors have been identified as playing a predictive role for severe obstetric morbidity. Conclusions. The decrease in maternal mortality has been influenced by several factors, including the increase in the number and quality of prenatal care, reducing the risk of maternal death from indirect causes. Another factors are the quality and promptness of hospital care, more relevant in the case of deaths from direct obstetric causes; nevertheless, the risk of death in this group is still almost double. The analysis of severe obstetric morbidity can be performed considering the following groups of predictors: demographics (over 34 years old, etc.), general medical (hypertension, etc.) and obstetric factors (multiple pregnancies, antenatal hospitalizations, emergency cesarean section, etc). Their identification can determine a focus on women who require higher attention during pregnancy.

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