IRELAND’S RATE of maternal deaths is still among the lowest in the world – but is up to four times higher than may be suggested by figures from the Central Statistics Office, a new report has claimed.
A triennial report from the Maternal Death Enquiry (MDE), which aims to apply international standards to figures for maternal deaths in the UK and Ireland, says there were 25 maternal deaths in the three years between 2009 and 2011.
In the same period, the CSO’s figures for deaths in ‘pregnancy, childbirth or puerperium’ (the period following childbirth) show that only six women had died in the same period – with three deaths in 2009, one in 2010 and two in 2011.
Of the 25 maternal deaths suggested by the MDE, six are classified as direct maternal deaths and thirteen as indirect maternal deaths, while the remaining six are attributed to ‘coincidental causes’.
When the third category is discounted, MDE believes Ireland’s maternal death rate for 2009 and 2010 is about 8.0 per 100,000 maternities – twice the CSO’s official figure for 2009.
Of the six deaths which came directly as as a result of maternity, three were caused by a pulmonary embolism, one by an amniotic fluid embolism, one by a uterine rupture, and one who suffered the failure of multiple organs as a result of HELLP syndrome, which is similar to pre-eclampsia.
MDE said it was encouraged to see that there were no deaths attributable to haemorrhage, complications from anaesthetic or hypertensive disease, which are all longstanding and more common causes of maternal deaths.
However, the presence of deaths as a result of various types of thrombosis posed a concern, it said.
Of the 13 indirect deaths, five were caused by cardiovascular disease and two by suicide. Two died from the H1N1 (‘swine flu’) strain of influenza, two from epilepsy, two from chronic and obstructive pulmonary disease, and one from excessive bleeding from esophageal varices.
Two of the six women who died coincidentally to maternity died of metastatic cancer, two from substance abuse, one from lymphoma and one died in a traffic accident.
Though non-Irish women account for a quarter of all Irish maternities, MDE Ireland’s report said they accounted for 40 per cent of the deaths identified in its 2009-2011 report – a similar figure to the previous report in for 2006-2008.
The report makes six recommendations, one of which is the inclusion of a question on pregnancy status at the death on a coroner’s death certificate.
The report also recommends considering the founding of a perinatal psychiatry mother-and-baby unit in Ireland.