MATERNAL MORTALITY IN SWEDEN, 1980-1988

Objective: To assess recent maternal mortality in Sweden according to the different definitions of the eighth, ninth, and tenth editions of the International Classification of Diseases (ICD). Methods: All mater nal deaths in Sweden during 1980- 1988 were sought in the Medical Birt h Registry and in the Registers of Births and Deaths. Hospital records and autopsy reports were requisitioned. Results: According to ICD-9, the maternal mortality ratio in Sweden for 1980-1988 was 7.4 per 100,0 00 live births. Of the 58 deaths, 36 were direct maternal deaths. Embo lism, hemorrhage, preeclampsia, and infection were the predominant cau ses in the direct cases. Advanced age was the most pronounced risk fac tor. Suboptimal standard of care was a contributing cause in almost on e-third of the direct maternal deaths. Accidental or incidental deaths , including suicide, accidents, and pregnancy-related deaths, added si x cases. There were 76 late maternal deaths, occurring 43-365 days pos tpartum. Malignancy, stroke, and heart disease were the predominant ca uses. After malignant disease, suicide constituted the leading cause o f pregnancy-related deaths within 1 year of delivery. Conclusions: Reg ular reviews of maternal mortality are still important in a country wi th a low rate of maternal deaths. The new classification of maternal d eaths allows a better international comparison of mortality risks. Con tinuous surveillance of maternal deaths and pregnancy-related deaths r equires record linkage of birth and death registrations.