Active Surveillance of Pregnancy-Related and Maternal Deaths
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Active Surveillance of Pregnancy-Related and Maternal Deaths: BACKGROUND
Active surveillance into pregnancy related and maternal death is most often done as part of Confidential Enquiries into Maternal Deaths, but can be used to obtain an estimate of the maternal mortality ratio. A key feature is the ongoing effort to actively identify potential maternal deaths as they occur. In the UK confidential enquiry, for example, health staff including midwives, obstetricians and general practitioners are encouraged to report any possible maternal deaths to a confidential enquiry assessor. In the USA, active surveillance is done using a modified death notification form, birth and death record linkage and active notification by individual practitioners, maternal mortality committees and even newspaper reports. In Egypt, maternal mortality surveillance is ongoing based on a modified death notification form and interviews with the families of all pregnancy related deaths.
Identification of death
Not Applicable (only potential pregnancy-related or maternal deaths are reviewed)
Ascertainment of maternal/pregnancy related status
Varied and sometimes multiple sources are used to identify and record all potential pregnancy-related deaths:
- Active reporting by Key Informants
- Maternal deaths ascertained by medical professionals (with or without diagnostic aids and/or autopsy)
- Verbal autopsy
Advantages:
- provides additional data on quality of care associated with maternal deaths
Limitations:
- requires complete death reporting and good cause of death data
- if multiple sources are used, duplicate deaths need to be avoided
- can be complex and time consuming to undertake, especially on a large scale
Measurement requirements:
- duplicate deaths need to be excluded
- sub-causes of maternal deaths must be coded and classified as maternal deaths
- data on births are needed to calculate MMR
- data on population of women aged 15-49 are needed to calculate MMRate
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Active Surveillance of Pregnancy-Related and Maternal Deaths: REFERENCES
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Daniel J. Pallin, MD, MPH, Vandana Sundaram, MPH, Fabienne Laraque, MD, MPH, Louise Berenson, MS, and David R. Schomberg, Rpa-C (2002) Active Surveillance of Maternal Mortality in New York City. Am J Public Health, August; 92(8): 1319-1322. |
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Drife, J (2006) Fifty years of the Confidential Enquiry in Maternal Deaths. British Journal of Hospital Medicine, Vol. 67(3): 121-5. |
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Drife, J (1999) Maternal mortality: lessons from the confidential enquiry. British Journal of Hospital Medicine, 60(3)3: 156-7. |
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Active Surveillance of Pregnancy-Related and Maternal Deaths: ADDITIONAL RESOURCES
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Ministry of Health. Evaluation of implementation of the confidential enquiries into maternal deaths in the improvement of maternal health services. Kuala Lumpur, Ministry of Health, 1998. |
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