Decreasing mortality during pregnancy and for a year after while mortality after termination of pregnancy remains high: a population-based register study of pregnancy-associated deaths in Finland 2001-2012.

OBJECTIVE: To investigate mortality in the non-pregnant fertile female population, and mortality during pregnancy and up to 1 year after the end of pregnancy, in Finland from 2001 to 2012 and compare the results with those of 1987-2000.

DESIGN: Retrospective cohort study.

SETTING: Finland.

POPULATION: 10 427 deceased women of reproductive age (15-49).

METHODS: Pregnancy outcomes were categorised into: ongoing pregnancy or birth, miscarriage or ectopic pregnancy and termination of pregnancy. Mortality was calculated per 100 000 pregnancies. The mortality rate of the non-pregnant female population of fertile age was calculated per 100 000 person-years, and the results were compared with those of 1987-2000.

MAIN OUTCOME MEASURES: Pregnancy-associated mortality during pregnancy and up to 1 year after the end of pregnancy. Mortality of non-pregnant, fertile-age, female population.

RESULTS: The age-adjusted mortality rate during pregnancy and within 1 year after the end of pregnancy was 28.4/100 000 pregnancies, and it had significantly decreased compared with the period 1987-2000 [risk ratio (RR) 0.75 (95% CI, 0.65-0.88)]. Mortality in non-pregnant fertile-age females was 48.1/100 000 person-years. Mortality for diseases and medical conditions during and after pregnancy decreased by 26% [RR 0.74 (95% CI, 0.59-0.92)] and for external causes by 23% [RR 0.77 (95% CI, 0.62-0.95)]. The mortality rate for suicides was 3.3/100 000 in ongoing pregnancies and pregnancies ending in birth while it was 21.8/100 000 after termination of pregnancy and 10.2/100 000 among non-pregnant women.

CONCLUSIONS: In comparison with earlier decades, pregnancy-associated mortality has decreased in Finland.

TWEETABLE ABSTRACT: Mortality decreases among pregnant women and within 1 year after pregnancy in Finland.