Shifting Paradigm in Cause of Maternal Mortality: A Pathway to Examine Obstetric Transition in West Bengal, India.

Mohammed Illias Sheikh , International Institute for Population Sciences
Balram Paswan, International Institute for Population Sciences (IIPS)
Tapan Naskar, Department of Obstetrics and Gynecology, Medical College and Hospital, Kolkata, India

Introduction: Previously, studies have manifested high magnitude of maternal deaths attributed to obstetric haemorrhage in West Bengal. But in the recent decade, the state has marked a unique recognition for having highest maternal mortality caused due to eclampsia in the country and globe. This underscores the need of the study to determine the incidence of maternal mortality attributed to eclampsia and identify the confounding factors associated with eclamptic maternal deaths. Data and Methods: The study adopted a retrospective facility-based maternal death review method. The study was conducted for all the maternal deaths occurred during January 2013 to December 2015 (N=437), in two tertiary level hospitals. Student's t-test was employed to compare incidence of eclampsia and meteorological parameters. Results: Study found more than one-third of maternal deaths attributed to eclampsia. Majority of patients (about three-fourths) developed antepartum eclampsia. The incidence of eclampsia during the study period was 1998 cases out of 78466 deliveries (2.55 cases per 100 deliveries). The result also confirmed a high level of case fatality rate (CFR- 8.63 percent). Occurrence of eclamptic deaths was highest (n=61) in monsoon and post monsoon, followed by in summer (n=50) and lowest in winter (n=40). The seasonal difference in the occurrence of eclamptic deaths between winter and monsoon & post monsoon as well as summer and winter has been found to be statistically significant. Conclusion: The study confirmed an excess risk of eclampsia, much higher compared to the previous studies which was the leading cause of maternal mortality in the study.

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 Presented in Session P2. Poster Session Ageing, Health and Mortality