Abstract
Surveillance for maternal death cases remains a significant challenge for many countries worldwide. The importance of determining the actual magnitude of the global maternal mortality problem is reflected in the study and application of methodologies that attempt to approximate the actual number of deaths using several sources of information. Traditionally, death certificates have been the best source of data, but unfortunately the diagnoses recorded in them are not always accurate, with the unfortunate result in the under-reporting of maternal deaths. In Mexico, surveillance for cases of maternal deaths is conducted by examining the main cause of death recorded in death certificates. In some situations, the evaluation of the cause(s) of a mother death needs to be clarified, and the relatives are then interviewed. In Yucatan, six studies have been conducted to analyze the under-reporting of maternal deaths. The percentage of state under-reporting for the period between 1997 and 2001 was 19%. The rates of under-reporting varied between 10.5% and 28.6%, and it decreased to 3% in the eastern area between 2002 and 2010. The main causes of maternal death under-reporting were errors regarding the interpretation of the death diagnosis and the completion of the death certificate, as well as omissions when codifying, even though the pregnancy, delivery, or puerperium conditions had been recorded. Therefore, we recommend the establishment of an effective and highly functional maternal death surveillance system, including medical education and training of medical professionals to recognize the causes of maternal death and to prepare death certificates and training of the individuals responsible for coding obstetrical complications to include the correct interpretation of the causes.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Acosta, C. D., & Knight, M. (2013). Sepsis and maternal mortality. Current Opinions in Obstetric & Gynecology, 25, 109–116. https://doi.org/10.1097/GCO.Ob013e32835e082
CEDES Centro de Estudios de Estado y Sociedad. (2004). Mortalidad materna en Argentina. Diagnóstico para la reorientación de políticas y programas de salud. Área Salud, Economía y Sociedad. Retrieved October 4, 2016, from http://www.fasgo.org.ar/archivos/ComSexRep/CEDES.pdf.
CEPAL Comisión Económica para América Latina. (2010). Reporte de avance en el ODM5 en América Latina y el Caribe. Mejorar la salud materna. Retrieved September 20, 2016, from http://www.cepal.org/MDG/noticias/paginas/2/40012/ODM_5.pdf.
Curtis, S. L., Mswia, M. G., & Weaver, E. H. (2015). Measuring maternal mortality: Three case studies using verbal autopsy with different platforms. PLoS One, 10(8), e0135062. http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0135062
FCI Family Care International. (2012). Estimaciones de la mortalidad materna en América Latina y el Caribe: Un breve panorama. Retrieved September 8, 2016, from http://www.familycareintl.org/UserFiles/File/GTR_SP.pdf.
Farquhar, C., Armstrong, S., Kimm, B., Mason, V., & Sadler, L. (2015). Under-reporting of maternal and perinatal adverse events in New Zealand. British Medical Journal Open, 5(7), e007970. https://doi.org/10.1136/bmjopen-2015-007970
Freyermuth-Enciso, G., & Cárdenas-Elizalde, R. (2009). Evaluación del subregistro de la mortalidad materna en Los Altos de Chiapas, mediante las estrategias RAMOS y RAMOS modificada. Salud Publica de Mexico, 51(6), 450–457.
INEGI Instituto Nacional de Estadística Geografía e Informática México. (2016). Estratificador INEGI. Retrieved October 11, 2016, from http://www.inegi.org.mx/est/contenidos/proyectos/estratificador/.
INEGI Instituto Nacional de Estadística Geografía e Informática México. (2015). Información por entidad. Número de habitantes. Retrieved October 12, 2016, from http://www.cuentame.inegi.org.mx/monografias/informacion/yuc/poblacion/default.aspx?tema=me&e=31.
Islam, M., & Yoshida, S. (2009). Women are still deprived of access to lifesaving essentials and emergency obstetric care. International Journal of Gynaecology and Obstetrics, 106(2), 120–124.
Karimian-Teherani, D., Haidinger, G., Waldhoer, T., Beck, A., & Vutuc, C. (2002). Under-reporting of direct and indirect obstetrical deaths in Austria. 1980-98. Acta Obstetricia et Gynecologica Scandinavica, 81(4), 323–327.
Kihuba, E., Gahara, D., Mwinga, S., Kospei, R., Mogoa, W., Nyamai, R., et al. (2014). Assessing the ability of health information systems in hospitals to support evidence-informed decisions in Kenya. Global Health Action, 7, 24859. https://doi.org/10.3402/gha.V7.24859. eCollection 2014.
Knight, M., Manisha, N., Brocklehurst, P., Kenyon, S., Neilson, J., Shakespeare, J., et al. (2016). Examining the impact of introducing ICD-MM on observed trends in maternal mortality rates in the UK 2003-13. BioMed Central Pregnancy and Childbirth, 16, 178–185. https://doi.org/10.1186/s12884-016-0959-z
Laurenti, R. (1988). Marcos referenciais para estudos e investigacoes em mortalidade materna. Revista de Saúde Pública, 22(6), 507–512.
Lewis, G. (2003). Beyond the numbers: Reviewing maternal deaths and complications to make pregnancy safer. British Medical Bulletin, 67, 27–37.
Lewis, G. (2008). Reviewing maternal deaths to make pregnancy safe. Best Practice & Research. Clinical Obstetrics & Gynaecology, 22, 447–463. https://doi.org/10.1016/j.bpobgyn.2007.10.007
McCaw-Binns, A. M., Mullings, J. A., & Holder, Y. (2015). Vital registration and under-reporting of maternal mortality in Jamaica. International Journal of Gynaecology and Obstetrics, 128, 62–67. https://doi.org/10.1016/j.ijgo.2014.07.023
Nove, A., Mathews, Z., Neal, S., & Camacho, A. V. (2014). Maternal mortality in adolescent compared with women of other ages: Evidence from 144 countries. Lancet Global Health, 2(3), e155–e164. https://doi.org/10.1016/S2214-109X(13)70179-7
Oliva, P., Santana, A., Andueza, G., Hoil, J., Ojeda, R., García, G., et al. (2016). Risk factors associated with domestic violence and homicidal violence of women: The case of Yucatan, Mexico. Psychology, 7, 62–73. https://doi.org/10.4236/psych.2016.71008
PAHO (Panamerican Health Organization). (1995). Clasificación estadística internacional de enfermedades y problemas relacionados con la salud, 10ª revisión. Retrieved August 9, 2016, from http://www.sssalud.gov.ar/hospitales/archivos/cie_10_revi.pdf.
PAHO-WHO Panamerican Health Organization-World Health Organization. (2013). Indicadores Básicos 2013. Indicadores demográficos. Retrieved September 12, 2016, from http://www.paho.org/per/images/stories/D y E/1B2013.pdf.
Rodríguez, E. (2010). Epidemiología sociocultural de las defunciones maternas en Yucatán, México. In G. Rosado (Ed.), Voces entretejidas (pp. 275–292). México: Instituto para la Equidad de Género en Yucatán. Gobierno del Estado de Yucatán.
Rodríguez, E., Andueza, G., Montero, L., & Hoil, J. (2005). Subregistro de muertes maternas en Mérida, Yuc. México (1997-2001). Ginecologia y Obstetricia de Mexico, 73(7), 347–354.
Rodríguez, E., Andueza, G., Montero, L., & Hoil, J. (2009). Subregistro de muertes maternas en comunidades mayas del oriente de Yucatán, México. Revista Biomedica, 20(2), 90–98.
Rodríguez, E., Andueza, G., Rosado, L., Ortiz, E., & Hernández, B. (2012a). Effect of a community-based intervention to improve the knowledge on the warning signs of maternal complications among Mayan women from Yucatan randomized controlled trial. Revista de Investigación Clínica, 64(2), 154–163.
Rodríguez, E., Aguilar, P., Montero, L., Hoil, J., & Andueza, G. (2012b). Demoras en la atención de complicaciones maternas asociadas a fallecimientos en municipios del sur de Yucatán, Mexico. Revista Biomedica, 23(1), 23–32.
Rodríguez, E., Andueza, G., & Montero, L. (2012c). Un abordaje cualitativo de las defunciones maternas en Tizimín, Yucatán, México. Alteridades, 22(43), 145–158.
Rodríguez, E., Montero, L., Andueza, G., & Manrique, W. (2007). Características médico-sociales de las muertes maternas en una comunidad maya de Yucatán, Méx. Ginecologia y Obstetricia de Mexico, 75(2), 79–85.
Rodríguez, E., & Ordóñez, M. (2006). Mortalidad materna y marginalidad. Revista Biomedica, 17(4), 237–242.
Rodríguez, E., Palma, M., & Zapata, R. (2014). Causas de demora en la atención de pacientes con complicaciones obstétricas ¿qué es necesario atender? Ginecología y Obstetricia de México, 82, 647–658.
Schwartz, D. A. (2015a). Unsafe abortion: A persistent cause of maternal death and reproductive morbidity in resource-poor nations. In D. A. Schwartz (Ed.), Maternal mortality: Risk factors, anthropological perspectives, prevalence in developing countries and preventive strategies for pregnancy-related death (pp. 425–439). New York: Nova Science Publishers.
Schwartz, D. A. (2015b). The pathology of maternal death - the importance of accurate autopsy diagnosis for epidemiologic surveillance and prevention of maternal mortality in developing countries. In D. A. Schwartz (Ed.), Maternal mortality: Risk factors, anthropological perspectives, prevalence in developing countries and preventive strategies for pregnancy-related death (pp. 215–253). New York: Nova Science Publishers.
Schwartz, D. A. (2015c). Interface of epidemiology, anthropology and health care in maternal death prevention in resource-poor nations. In D. A. Schwartz (Ed.), Maternal mortality: Risk factors, anthropological perspectives, prevalence in developing countries and preventive strategies for pregnancy-related death (pp. ix–xiv). New York: Nova Science Publishers.
SEGOB Secretaría de Gobernación México. (2016). Norma Oficial Mexicana NOM-007-SSA2–2016, Para la atención de la mujer durante el embarazo, parto y puerperio y de la persona recién nacida. Retrieved May 24, 2016, from https://drive.google.com/file/d/0B_Wsl17nCOpWNGtjd1dYSTZXYzQ/view.
Simoes, P. P., & Almeida, R. M. (2011). Geographic accessibility to obstetric care and maternal mortality in a large metropolitan area of Brazil. International Journal of Gynaecology and Obstetrics, 12, 25–29. https://doi.org/10.1016/j.ijgo.2010.07.031
Turner, L. A., Cyr, M., Kinch, R. A., Liston, M., Kramer, R. S., Fair, M., et al. (2002). Under-reporting of maternal mortality in Canada: A question of definition. Chronic Disease in Canada, 23(1), 22–30.
WHO. (2016). Application of ICD-10 to deaths during pregnancy, childbirth and the puerperium; ICD-MM. Retrieved September 12, 2016, from http://apps.who.int/Iris/bitstream/10665/70929/1/9789241548458_eng.pdf?ua=1.
WHO World Health Organization. (2004). Beyond the numbers: reviewing maternal deaths and complications to make pregnancy safer. Retrieved October 4, 2016, from http://apps.who.int/iris/bitstream/10665/42984/1/9241591838.pdf.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2018 Springer International Publishing AG, part of Springer Nature
About this chapter
Cite this chapter
Rodríguez-Angulo, E.M., Hoil-Santos, J.J., Ojeda-Rodríguez, R. (2018). Problems with Epidemiological Surveillance and Under-Reporting of Maternal Deaths in Yucatan, Mexico: An Analysis of Six Studies. In: Schwartz, D. (eds) Maternal Death and Pregnancy-Related Morbidity Among Indigenous Women of Mexico and Central America. Global Maternal and Child Health. Springer, Cham. https://doi.org/10.1007/978-3-319-71538-4_15
Download citation
DOI: https://doi.org/10.1007/978-3-319-71538-4_15
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-71537-7
Online ISBN: 978-3-319-71538-4
eBook Packages: MedicineMedicine (R0)