Patterns and causes of hospital maternal mortality in a tertiary center in Nigeria: A 9-year retrospective review

Background: Maternal mortality is a preventable public health challenge in sub-Saharan Africa including Nigeria. Reporting of its trend and causes is important in auditing of care. Objectives: The study is aimed at evaluating the trends, causes, and maternal mortality rate in Alex Ekwueme Federal University Teaching Hospital Abakaliki (AEFUTHA), Ebonyi State, Nigeria. Materials and Methods: This is a 9-year retrospective review of case note of maternal deaths (MDs) in AEFUTHA. All pregnancy-related deaths of patients managed at the hospital were included in the study. Data obtained were analyzed using IBM SPSS Statistics version 20. Results: The maternal mortality ratio (MMR) was 1,114 per 100,000 live births. The MMR remained high at above 1,100 per 100,000 live births between 2012 and 2016; and a sharp decline was seen between 2017 and 2020. The lowest MMR was in 2018 (512 per 100,000 live births). Most of the MDs occurred in unbooked (85.4%) and grand multiparous (43.4%) women. Obstetric hemorrhage was the leading cause of death (28.0%), followed by hypertensive disorders of pregnancy. Less than 3% of MD was caused by Lassa fever. Women with low socioeconomic status, lower level of education, and rural place of abode were major contributors to MD. Conclusion: Our study shows that MD is unacceptably high in the hospital. The burden of MD is borne by unbooked and grand multiparous women. Obstetric population should be educated on the importance of antenatal care and the need for family size reduction via the use of modern method of contraception.