A Case-control Study On The Risk Factors Of Maternal Mortality In Rural Areas Of Yunnan Province

Objective To understand the risk factors of maternal mortality in rural areas of Yunnan Province, as well as to provide evidence-based recommendations to make up prevention strategies and measures for reducing maternal mortality.Methods A 1:2 case-control method has been applied in this research. From June, 2009 to September,2010, according to information reported by monitoring network of maternal mortality in Yunnan Province,100 families with pregnant women who dead over 28 weeks pregnancy or within 42 days after delivery (except accident death) as study group. Meanwhile,196 families were selected as control group from the same administration village or neighboring villages, based on their family structure, residence, family economic status. All the samples were interviewed using by self-designed questionnaire for face to face in their households.Results The top five causes of maternal death were Obsteric hemorrhage,amniotic fluid embolization, pregnancy hypertension, the constituent ratio were:48.0%,19.0%,13.0%. By control of economics, in Monofactor Logistic Regression Analysis showed education level of women, woman's age, husband's age, number of children before this pregnancy, times of prenatal check up, delivery sites, delivery patterns, and transferring time pregnant woman from household to hospital were significantly associated with maternal mortality. Multifactor Logistic Regression Analysis indicated that the elder of deliver age (OR=1.109), lacking of prenatal check up (OR=9.165), cesarean section (OR=4.883) and time of transferring to hospital (OR=1.043) were strongly associated with maternal mortality.Conclusions Obsteric hemorrhage was the first of cause maternal deaths in rural Yunnan. The elder pregnant or the deliver age, accessibility of health care service and poor capability of obstetric skill service are major risk factors of maternal mortality. It is suggest that promoting maternity health care equality, strengthening screening management of high risk factors for pregnant women, and improving the capability of maternal health care services provider are to reducing maternal mortality in an effective way.