Risk factors for in-hospital maternal mortality in the region of Maradi, Niger (2008-2010: A retrospective study of 7 regional maternity units.

In the Maradi region, despite multiple efforts to reduce maternal mortality the in-hospital maternal mortality ratio (HMMR) remains high. We sought to determine the factors related to maternal mortality in seven maternity units in this region. A retrospective study reviewed records of deliveries from January, 2008, through December, 2010. Data for all maternal deaths were collected. The Chi2 test was used to determine the significance of differences between groups for the different variables. Statistical significance was defined as P < 0.05. Data were analyzed with Epi Info© 3.5.1. The in-hospital maternal mortality ratio (HMMR) was 2,512 per 100,000 live births. Women aged 14 to 19 years were most affected, accounting for 27.1 % of deaths. In all, 93 (27.4 %) women died during their pregnancy. Direct obstetric causes accounted for 53.61 % of these deaths, and indirect causes 46.39 %. The bivariate analysis showed that age 14 to19 years (Chi2 = 64.69; P = 0.00000178); great multiparity (Chi2 = 64.69; P = 0.00000124), primiparity (Chi2 = 18.82; P = 0.000016), the third trimester of pregnancy (Chi2 = 10.43; P = 0.0054) were significantly associated with maternal death. It is therefore necessary to strengthen women's awareness about the risks of early pregnancy and the immediate use of health services.