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  • Title: [Maternal mortality rates in the IMSS].
    Author: Mojarro O, Hernandez D.
    Journal: Demos; 1991; (4):6-7. PubMed ID: 12158048.
    Abstract:
    Data are presented on maternal mortality in the Mexican Institute of Social Security (IMSS) system. World Health Organization recommendations for the definition and measurement of maternal mortality were followed. Death certificates were used to estimate mortality levels, data on the number of live births were used to calculate death rates, and reports of the Study Committees on Maternal Mortality were used to analyze causes of death. Maternal mortality rates declined during the 1980s from 59.9/100,000 live births in 1982-84 to 42.4 in 1987-89, a reduction of 29%. The overall maternal mortality rate in Mexico was estimated at 65/100,000 in 1986. The declining maternal mortality rate, in the context of deteriorating living conditions of the population, appears to be due primarily to the effect of greater coverage of prenatal care, prevention of pregnancies, and a greater relative number of pregnancies at younger ages. Maternal mortality in 1982-84 formed a J-shaped curve in which mortality of younger mothers was higher than that of mothers in intermediate age groups but not as high as that of mothers in the oldest groups. The J-shaped curve was no longer observed in 1987-89, probably because of application of the risk focus in obstetric services and the reproductive risk focus in family planning services. The 5 principal causes of maternal deaths, according to the Study Committees on Maternal Mortality, were toxemia, hemorrhages of pregnancy or delivery, puerperal sepsis, abortion complications, and other complications in the puerperium. These causes accounted for almost 80% of maternal deaths in 1984-86. The decline in the maternal mortality rate does not appear to be associated with reduction in any of the 5 main causes of death except abortion. Greater availability of family planning services contributed to a reduction in the rate of complications of abortion attended by IMSS facilities from 13.7 to 8.0 per 1000 fertile-aged women during the 1980's. Improved prenatal care and attention before, during, and immediately after delivery are urgently needed in order to improve maternal mortality rates even more. Also required are improved training of health personnel and education of the population in detection of reproductive risk so that high risk populations can be counseled and obstetrical risk recognized in time to seek help.
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