MALARIA-RELATED MATERNAL MORTALITY IN URBAN MOZAMBIQUE

All pregnancy-related maternal deaths that occurred at the central hos pital of Maputo during the 5 years between 1989 and 1993 were reviewed . The 239 maternal deaths recorded represented a maternal mortality ra tio of 320/100 000 live births. Overall, 15.5% of the deaths were dire ctly attributable to malaria, and 19.7% of the women who died were fou nd to be parasitaemic (with Plasmodium falciparum) prior to death. Aut opsies on 161 of the women who died showed histological evidence of ma larial infection in the spleens of 44 (27.3%). Many (37.8%) of the mal aria-related deaths occurred in adolescent primigravidae, and most wer e associated with severe anaemia. Pregnancy outcome was generally poor . Unbooked deliveries, and poor antenatal care were identified as risk factors for maternal death from malaria. The current policy of prescr ibing antimalarials in pregnancy based on symptomatic malaria alone sh ould be reviewed. Improved primary prevention is required in order to reduce the high risk of malaria-related mortality in all pregnant wome n in the urban study area, especially among adolescents.