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  • Title: Biosocial factors in maternal mortality: a study from a Nigerian mission hospital.
    Author: Olusanya O, Amiegheme N.
    Journal: Trop J Obstet Gynaecol; 1988; 1(1):88-9. PubMed ID: 12179288.
    Abstract:
    A survey of deaths occurring in women in association with pregnancy and childbirth was carried out in a large mission hospital in Benin City, Nigeria to identify the underlying biosocial factors. During an 18- month period, January 1, 1985 to June 30, 1986, 5688 live births and 19 maternal deaths were recorded; 2 from abortions were excluded. Age, parity, booking status, level of educational attainment and socio economic status were all found to be important variables statistically affecting maternal death risks. Specifically, women between 20-29 years were found to carry the lowest risk of dying during pregnancy and childbirth, while those at highest risks were the 15-19 years and the 30-34 years age groups who had maternal mortality rate (MMR) of 3 times the average. MMR was found to be lowest in women with 1-6 children. 30% of all maternal deaths occurred in women who were booked; the MMR amongst booked women was 1.03/1000 live births compared to 14.07 among unbooked women. Women with no formal education were found to have a 2- fold risk of maternal death compared to women who had attended school past the secondary school level. A positive correlation was found between poor social class and high risk from maternal death. No significant association was found in the study between maternal death risks and other social variables such as marital status, distance of home from hospital, and ethnic origin of pregnant women. Lack of antenatal care increases the maternal death risk by more that 10-fold. Maternal deaths were shown to be an index of the socio economic standards in any society. In order to make any genuine attempt at reducing the maternal mortality rate, the proportion of high-risk groups which are socio economically derived must be drastically reduced. Measures to lower the present high rates of maternal mortality in Nigeria and other developing countries through a manipulation of these biosocial factors include discouraging teenage girls, women 35 years, and women having 5 or more children from getting pregnant and providing them with contraception. Appropriate policies should be instituted to promote education of women and to enhance the upward social mobility of the socio economically deprived segments of the population. Furthermore, medical services should approach acceptable world standards.
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