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Abstract
Background: decreasing the number of maternal deaths remains a global priority. The World Health Organization (WHO) has published a series of systematic analyses on causes of maternal deaths, using published scientific literature and government reports. The first analysis published in 2006 assessed the causes of death from 1990 to 2002. In 2014, a second analysis covered maternal mortality causes from 2003 to 2009; showing that direct causes such as haemorrhage, hypertensive disorders, and sepsis accounted for over 50% of all maternal deaths. WHO has developed a protocol to estimate the causes of maternal deaths at national, regional and global levels for the period from 2009 to 2016. We will compare these estimates to the previously published WHO studies to describe temporal trends.
Objectives: the primary objective is to develop levels and trends estimates at national, regional and global levels for the proportion of all direct and indirect causes of maternal deaths; hypertensive disorders, obstetric haemorrhage, pregnancy-related infection, suicide deaths, abortion deaths, and indirect complications.
Methods: WHO commissioned Cochrane Response to develop the search strategies, to screen abstracts and full texts, and to extract data, including 'Risk of bias' assessments. We conducted a comprehensive search with no language limits in February 2018 in MEDLINE, Embase, Global Index Medicus, Web of Science and Popline. We planned an update for April 2019. Specialist teams conducted searches in relevant Chinese and Russian databases. Data are also being retrieved from Ministries of Health and National Statistics offices.
Some changes included in this update are a more systematic search of non-Western databases, eligibility of papers that include only one cause of death, and consideration of subnational/ health facility-based studies. We applied eligibility criteria for timeframe, study design, population, and setting (PROSPERO 2019 CRD42019121340) and followed standard Cochrane methods.
We created a comprehensive data extraction form after full consultation with the WHO team. Death categorization is in line with the WHO ICD-10 classification. We developed three 'Risks of bias' forms to assess evidence from diverse data sources.
Results: the preliminary results of this work will be presented at the Colloquium. The first search identified 53,738 records, 402 of which have been included in data extraction. We estimate the search update will identify another 8000 records.
Conclusions: reducing maternal deaths requires understanding why those deaths occur. WHO is leading the technical activities to produce updated official estimates. Components of this complex project have been commissioned to Cochrane Response. Successful completion requires working in close partnership with the commissioner and having access to review authors with diverse methodological skills.
Patient or healthcare consumer involvement: none
Objectives: the primary objective is to develop levels and trends estimates at national, regional and global levels for the proportion of all direct and indirect causes of maternal deaths; hypertensive disorders, obstetric haemorrhage, pregnancy-related infection, suicide deaths, abortion deaths, and indirect complications.
Methods: WHO commissioned Cochrane Response to develop the search strategies, to screen abstracts and full texts, and to extract data, including 'Risk of bias' assessments. We conducted a comprehensive search with no language limits in February 2018 in MEDLINE, Embase, Global Index Medicus, Web of Science and Popline. We planned an update for April 2019. Specialist teams conducted searches in relevant Chinese and Russian databases. Data are also being retrieved from Ministries of Health and National Statistics offices.
Some changes included in this update are a more systematic search of non-Western databases, eligibility of papers that include only one cause of death, and consideration of subnational/ health facility-based studies. We applied eligibility criteria for timeframe, study design, population, and setting (PROSPERO 2019 CRD42019121340) and followed standard Cochrane methods.
We created a comprehensive data extraction form after full consultation with the WHO team. Death categorization is in line with the WHO ICD-10 classification. We developed three 'Risks of bias' forms to assess evidence from diverse data sources.
Results: the preliminary results of this work will be presented at the Colloquium. The first search identified 53,738 records, 402 of which have been included in data extraction. We estimate the search update will identify another 8000 records.
Conclusions: reducing maternal deaths requires understanding why those deaths occur. WHO is leading the technical activities to produce updated official estimates. Components of this complex project have been commissioned to Cochrane Response. Successful completion requires working in close partnership with the commissioner and having access to review authors with diverse methodological skills.
Patient or healthcare consumer involvement: none
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