Ff. Fikree et al., A COMMUNITY-BASED NESTED CASE-CONTROL STUDY OF MATERNAL MORTALITY, International journal of gynaecology and obstetrics, 47(3), 1994, pp. 247-255
Objectives: Population-based information from Pakistan on maternal mor
tality is inadequate to define the magnitude of the problem or to cont
ribute information on the distribution of clinical causes and risk fac
tors. A population-based survey was conducted in eight urban squatter
settlements of Karachi Pakistan, to address these key issues. Methods:
Pre-coded questionnaires were administered to the 10 135 households t
o ascertain deaths of household members in the 5 years preceding the s
urvey (1984-1989). A verbal autopsy questionnaire was administered to
the 121 households where a female death between 15 and 49 years of age
was reported. Results: The maternal mortality ratio was estimated as
281 per 100 000 livebirths with hemorrhage, eclampsia and puerperal se
psis as the major causes of maternal deaths. Important risk factors id
entified were maternal employment, paternal unemployment, and poor pri
or pregnancy history. Women did seek health care but the assistance so
ught was often inappropriate. Conclusion: Intervention programs for im
proving timely referral and upgrading of hospitals are suggested.