Maternal Mortality: In-Depth Review of Maternal Death in a Referral Hospital in Jigawa State Nigeria
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Background: Maternal mortality remains a major public health challenge in Nigeria. In 2023, Nigeria accounted for approximately 28.5% of global maternal deaths despite representing only 2.6% of the world’s population. This study aims to determine the maternal mortality ratio (MMR) and identify factors contributing to maternal deaths at Rasheed Shekoni Federal University Teaching Hospital (RSFUTH), Dutse.
Methods: A retrospective review of maternal deaths that occurred in the Department of Obstetrics and Gynaecology, RSFUTH, between 1 December 2023 and 30 November 2024 was conducted. Relevant information was extracted from patients’ case files using a structured proforma. Data were analyzed using IBM SPSS version 26. Descriptive statistics were presented as frequencies and percentages, while associations were tested using Fisher’s exact test at a significance level of p<0.05.
Results: During the study period, 768 deliveries and 30 maternal deaths were recorded, resulting in an MMR of 3,906 per 100,000 live births. Two cases were excluded from analyses of causes and contributory factors because of incomplete records. The mean age of the women was 26.5 ± 8.6 years, with over half (53.6%) aged 15–25 years. Most women resided in rural areas (67.9%), were homemakers (92.8%), and had no formal or Qur’anic education (60.8%). Hypertensive disorders of pregnancy (32.1%) and puerperal sepsis (28.5%) were the leading causes of death. Most women (87.5%) delivered in hospitals, while 75% of deaths occurred during the postpartum period. More than half (57.1%) died within 1–7 days of admission.
Conclusion: Maternal mortality at RSFUTH was extremely high. Hypertensive disorders of pregnancy and puerperal sepsis were the leading causes, while inadequate treatment, limited equipment and infrastructure, and delays in referral contributed significantly to maternal deaths.
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1. Olonade, O., Olawande, T. I., Alabi, O. J., & Imhonopi, D. (2019). Maternal mortality and maternal health care in Nigeria: Implications for socio-economic development. Macedonian Journal of Medical Sciences, 7, 849–855.
2. World Health Organization. (2013). WHO guidance for measuring maternal mortality from a census. https://tinyurl.com/yxcap84u
3. Geller, S. E., Koch, A. R., Garland, C. E., MacDonald, E. J., Storey, F., & Lawton, B. (2018). A global view of severe maternal morbidity: Moving beyond maternal mortality. Reproductive Health, 15, 32–43.
4. Sageer, R., Kongnyuy, E., Adebimpe, W. O., Omosehin, O., Ogunsola, E. A., & Sanni, B. (2018). Causes and contributory factors of maternal mortality: Evidence from maternal and perinatal death surveillance and response in Ogun State, Southwest Nigeria. BMC Pregnancy and Childbirth, 19, 63.
5. World Health Organization, United Nations Population Fund, & United Nations Children’s Fund. (1992). Traditional birth attendants: A joint WHO/UNFPA/UNICEF statement. World Health Organization. https://apps.who.int/iris/handle/10665/38994
6. World Health Organization, United Nations Children’s Fund, United Nations Population Fund, World Bank Group, & United Nations Department of Economic and Social Affairs. (2023). Trends in maternal mortality 2000 to 2020: Estimates by WHO, UNICEF, UNFPA, World Bank Group and UNDESA/Population.
7. National Population Commission (Nigeria) & ICF. (2019). 2018 Nigeria DHS key findings.
8. Oye-Adeniran, B., Odeyemi, K., Gbadegesin, A., Akin-Adenekan, O., Akinsola, O., & Ekanem, E. (2014). Causes of maternal mortality in Lagos State, Nigeria. Annals of Tropical Medicine and Public Health, 7, 177–181.
9. Ogu, R. N., Agholor, K. N., & Okonofua, F. E. (2016). Engendering the attainment of SDG-3 in Africa: Overcoming the sociocultural factors contributing to maternal mortality. African Journal of Reproductive Health, 20, 62–74.
10. Piane, G. M. (2019). Maternal mortality in Nigeria: A literature review. World Medical & Health Policy, 11, 83–94. https://doi.org/10.1002/wmh3.291
11. Doctor, H. V., Findley, S. E., & Afenyadu, G. Y. (2012). Estimating maternal mortality level in rural northern Nigeria by the sisterhood method. International Journal of Population Research, 2012, 464657.
12. Maduka, O., & Ogu, R. (2020). Preventing maternal mortality during childbirth: The scourge of delivery with unskilled birth attendants. In M. Z. Jovandaric & S. J. Milenkovic (Eds.), Childbirth. IntechOpen. https://doi.org/10.5772/intechopen.90463
13. Adewuyi, E. O., Khanal, V., Zhao, Y., David, L., Bamidele, O. D., & Auta, A. (2019). Home childbirth among young mothers aged 15–24 years in Nigeria: A national population-based cross-sectional study. BMJ Open, 9, e025494. https://doi.org/10.1136/bmjopen-2018-025494
14. Chinkhumba, J., De Allegri, M., Muula, A. S., & Robberstad, B. (2014). Maternal and perinatal mortality by place of delivery in sub-Saharan Africa: A meta-analysis of population-based cohort studies. BMC Public Health, 14, 1014.
15. Hussein, J., Hirose, A., Owolabi, O., Imamura, M., Kanguru, L., & Okonofua, F. (2016). Maternal death and obstetric care audits in Nigeria: A systematic review of barriers and enabling factors in the provision of emergency care. Reproductive Health, 13, 47.
16. Okonofua, F., Ogu, R., & Agholor, K. (2017). Qualitative assessment of women’s satisfaction with maternal health care in referral hospitals in Nigeria. Reproductive Health, 14, 44.
17. Okonofua, F. E., Abejide, A., & Makanjuola, R. A. (1992). Maternal mortality in Ile-Ife, Nigeria: A study of risk factors. Studies in Family Planning, 23, 319–324.
18. Sharma, V., Brown, W., Kainuwa, M. A., Leight, J., & Nyqvist, M. B. (2017). High maternal mortality in Jigawa State estimated using the sisterhood method. BMC Pregnancy and Childbirth, 17, 163. https://doi.org/10.1186/s12884-017-1341-5
19. Oladapo, O. T., Adetoro, O. O., Ekele, B. A., & Chama, C. (2016). When getting there is not enough: A nationwide cross-sectional study of 998 maternal deaths and 1451 near-misses in public tertiary hospitals in a low-income country. BJOG: An International Journal of Obstetrics & Gynaecology, 123, 928–938.
20. Ntoimo, L. F., Okonofua, F. E., Ogu, R. N., Galadanci, H., Gana, M., & Okike, O. N. (2018). Prevalence and risk factors for maternal mortality in referral hospitals in Nigeria: A multicenter study. International Journal of Women’s Health, 10.
21. Adamu, Y. M., Salihu, H. M., Sathiakumar, N., & Alexander, G. R. (2003). Maternal mortality in northern Nigeria: A population-based study. European Journal of Obstetrics & Gynecology and Reproductive Biology, 109, 153–159.
22. Kassebaum, N. J., Bertozzi-Villa, A., Coggeshall, M. S., Shackelford, K. A., Steiner, C., Heuton, K. R., et al. (2014). Global, regional, and national levels and causes of maternal mortality during 1990–2013: A systematic analysis for the global burden of disease study 2013. The Lancet, 384, 980–1004.
23. Kibret, G. D., Demant, D., & Hayen, A. (2023). The effect of distance to health facility on neonatal mortality in Ethiopia. BMC Health Services Research, 23, 114. https://doi.org/10.1186/s12913-023-09070-x
24. Fagbamigbe, A. F., & Idemudia, E. S. (2015). Assessment of quality of antenatal care services in Nigeria: Evidence from a population-based survey. Reproductive Health, 12, 88. https://doi.org/10.1186/s12978-015-0081-0
25. Azodoh, V. N., Ijadunola, Y. M., & Bamidele, M. (2021). Quality of antenatal care services in primary healthcare centers in the Federal Capital Territory, Abuja, Nigeria: A cross-sectional study. Anatolian Journal of Family Medicine, 3, 232–237. https://doi.org/10.5505/anatoljfm.2020.527