[Maternal mortality in the IMSS: an analysis from the perspective of mortality and lethality]

Abstract

Objective: To assess the incidence of hospital maternal mortality in the population covered by the Mexican Institute of Social Security (IMSS) from 2000 to 2003, utilizing the rates of the main causes of morbidity and lethality, in order to gain a better understanding of this epidemiological picture.

Methods: We collected information from 3,357,346 hospital deliveries and 832 maternal deaths that occurred in the medical units of the IMSS during the above-mentioned years. For the specific analysis of mortality, morbidity and lethality, deliveries and deaths with diagnoses of mild preeclampsia, severe preeclampsia, eclampsia, placenta previa, postpartum hemorrhage, chorioamnionitis and puerperal sepsis were selected, based on the criteria of International Diseases Classification, Tenth Revision. For statistical differences we used the chi(2).

Results: Maternal mortality registered a reduction of 25.1% (39 x 100,000 live births in 2000 and 29.2% in 2003). Morbidity increased by 6.6%. Morbidity and lethality caused by preeclampsia, obstetrical hemorrhages and puerperal sepsis (56.7% of the total deaths) showed a significant decrease in most cases. Specific morbidity showed no changes.

Conclusions: We observed a decrease in the rate of hospital maternal mortality during the years of the study, linked to a reduction in lethality of these three main causes. This epidemiological picture may demonstrate the optimal quality in obstetrical care, because no reported changes in morbidity levels were registered.