Epidemiological assessment of long-term maternal and failed maternal mortality

Objective. To conduct epidemiological studies of the long-term dynamics of maternal mortality (MM) and failed maternal mortality, development of trends and territorial distribution.

Materials and methods. The data of official statistics on maternal mortality calculated for

100 000 live births and a long-term dynamics of unrealized maternal mortality according to the data of the Ministry of Healthcare of PK "Unified Information System of Healthcare of Perm Krai" are presented. The number of cases of complicated pregnancy, childbirth and the postpartum period with the formation of multiple organ dysfunction or insufficiency requiring intensive therapy, blood transfusion and emergency surgical interventions was calculated. The epidemiological descriptive and evaluative method was used when performing the studies. The long-term dynamics of MM was calculated, the rectilinear epidemic trend for the function of the parabola y1 = a + bx and the curvilinear tendency for the function of the parabola y2 = a + bx + c2, its upper and lower confidence bounds (Me ± 0.95) were determined. The rate of growth and increment were investigated and the research cyclical fluctuations were determined.

Results. The maximum level of maternal losses (ML) in Perm Krai established in 2003 was 44.2 per 100 thousand live births. The minimum figure in 2015 was 5.2 per 100 thousand live births. The average long-term indicator of MM is 19.3. A feature of the long-term dynamics of the studied period was a steady decline in MM with an average annual rate of 5.7 %. Cyclical fluctuations were initially regular in nature, and subsequently had a lengthened rhythm of 13 years. Failed maternal mortality in Perm Krai had a pronounced downward trend; the decrease rate was 518.9 %. The annual loss rate was 69.8 %.

Conclusions. The long-term dynamics of MM in Perm Krai was characterized by an average degree of intensity, an epidemic tendency to decrease, the presence of cyclical fluctuations, the formation of internal causes testifying to the possible activation of maternal losses. The long-term dynamics of failed maternal mortality had a pronounced downward trend.