Study | Site | Study design/data collection methods | Years | Adolescent age group | Number of adolescent deaths included | Causes of maternal deaths identified | ||
---|---|---|---|---|---|---|---|---|
Sub-Saharan Africa | Ā | Ā | Ā | Ā | Adolescent group | Comparison group (where available) | ||
Asamoah B, Moussa K, Stafstrom M, Musinguzi G (2011) [18] | Ghana | Retrospective community survey with verbal autopsy questionnaire (Demographic and Household Survey) | 2000ā2005 | 12ā19 years (as part of sample 12ā49 years: 12ā14 and 15ā19 were presented separately but were amalgamated when figures recalculated due to only three deaths in 12ā14 age group) | 65 (as a sub- sample of 605 maternal deaths aged 12ā49) | Ā | 12ā19 years | 12ā49 years |
TotalĀ Direct | 62Ā % | 61Ā % | ||||||
Abortion | 29Ā % | 14Ā % | ||||||
Haemorrhage | 11Ā % | 23Ā % | ||||||
(Pre) eclampsia | 8Ā % | N/A | ||||||
Sepsis | 6Ā % | 7Ā % | ||||||
Obstructed labour | 5Ā % | 5Ā % | ||||||
Miscarriage | 3Ā % | 3Ā % | ||||||
Hypertensive disorders | N/A | 9Ā % | ||||||
Total Indirect | 38Ā % | 40Ā % | ||||||
Other infectious diseases | 14Ā % | 14Ā % | ||||||
Other non-infectious diseases | 12Ā % | 12Ā % | ||||||
Miscellaneous | 12Ā % | 14Ā % | ||||||
Figures were recalculated because theĀ dataĀ were presented as cause specific mortality by ageĀ group rather than adolescent mortality by cause | ||||||||
Ghana Statistical Service (GSS), Ghana Health Service (GHS), and Macro International (2009) [22] | Ghana | Retrospective community survey with verbal autopsy questionnaire (Demographic and Household Survey) | 2000ā2005 | 12ā14 and 15ā19 (as part of sample 12ā49 years: 12ā14 and 15ā19 were presented separately but were amalgamated when figures recalculated due to only three deaths in 12ā14 age group) | 56 aged 12ā19 (as a sub-sample of 486 maternal deaths aged 12ā49) | Ā | 12ā19 years | 12ā49 years |
Abortion | 29Ā % | 11Ā % | ||||||
Haemorrhage | 12Ā % | 24Ā % | ||||||
Hypertensive disorders | 9Ā % | 9Ā % | ||||||
Sepsis | 7Ā % | 7Ā % | ||||||
Miscarriage | 4Ā % | 4Ā % | ||||||
Obstructed labour | 3Ā % | 4Ā % | ||||||
Other miscellaneous | 9Ā % | 13Ā % | ||||||
Other not classified elsewhere: infectious | 15Ā % | 15Ā % | ||||||
Other not classified elsewhere: non-infectious | 12Ā % | 13Ā % | ||||||
MallĆ© D, Ross DA, Campbell O, Huttly S (1994) [23] | Mali (Bamako, Sissako and Mopti) | Retrospective study using data from 25 health facilities | 1988 to 1992 | 14ā19 years | 54 aged 14ā19 as a sub-sample of 288 maternal deaths aged 14ā49 | Ā | 14ā19 years | 14ā49 years |
Haemorrhage | 46Ā % | 59Ā % | ||||||
Toxaemia | 30Ā % | 14Ā % | ||||||
Infection | 17Ā % | 13Ā % | ||||||
Other | 7Ā % | 14Ā % | ||||||
Granja A CL, Machungo F, et al. (2001) [24] | Mozambique | Retrospective hospital based Study | 1989ā1993 | Under 20 (with a comparison non-adolescent group aged 20ā45) | 52 (with a further 80 non-adolescent deaths) | Ā | <20Ā years | 20ā45 years |
Total Direct | 54Ā % | 61Ā % | ||||||
Pregnancy-induced hypertension/eclampsia | 21Ā % | 9Ā %* | ||||||
Puerperal infection | 15Ā % | 10Ā % | ||||||
Abortion | 10Ā % | 7Ā % | ||||||
Haemorrhage | 4Ā % | 33Ā %** | ||||||
Amniotic fluid embolism | 4Ā % | 2Ā % | ||||||
Total Indirect | 47Ā % | 38Ā % | ||||||
Malaria | 27Ā % | 12Ā %** | ||||||
Anaemia | 6Ā % | 6Ā % | ||||||
Meningitis | 6Ā % | 4Ā % | ||||||
Other indirect | 6Ā % | 16Ā % | ||||||
Lema VM, Changole J, Kanyighe C, Malunga EV (2005) [29] | Malawi | Retrospective study using tertiary health facility data | 1999ā2000 | 10Ā§Ā§ā19Ā years (as part of a sample aged 16ā40) | 42 (as a subset of the total sample of 204 maternal deaths aged 10ā40) | Ā | 10ā19 years | 16ā40 years |
Postabortal sepsis | 36Ā % | N/A | ||||||
Puerperal sepsis | 21Ā % | 29Ā % | ||||||
Postabortal haemorrhage | 10Ā % | N/A | ||||||
Ectopic pregnancy | 10Ā % | 3Ā % | ||||||
Meningitis | 10Ā % | 10 % | ||||||
Pneumonia | 10Ā % | N/A | ||||||
Eclampsia | 2Ā % | N/A | ||||||
Other | 2Ā % | 6Ā % | ||||||
Postabortal complications | N/A | N/A | ||||||
Other infections | N/A | 24Ā % | ||||||
Obstetric haemorrhage | N/A | 20Ā % | ||||||
Ruptured uterus/obstructed labour | N/A | 11Ā % | ||||||
Heart failure (due to anaemia) | N/A | 3Ā % | ||||||
Not established | N/A | 2Ā % | ||||||
Ā | Ā | 3Ā % | ||||||
Nkata M (1997) [28] | Zambia (Luapula province) | Retrospective study using secondary level hospital data | 1993ā5 | 13ā19 years | 33 | Ā | 13ā19 years | No comparison data available |
Total Direct | 69Ā % | Ā | ||||||
Sepsis due to: | Ā | Ā | ||||||
- Obstructed labour with uterine rupture | 36Ā % | Ā | ||||||
- Obstructed labour without uterine rupture | 9Ā % | Ā | ||||||
- Abortion | 9Ā % | Ā | ||||||
- Puerperal sepsis | 3Ā % | Ā | ||||||
Haemorrhage due to: | Ā | Ā | ||||||
- Caesarean section | 6Ā % | Ā | ||||||
- Ectopic pregnancy | 3Ā % | Ā | ||||||
Eclampsia | 3Ā % | Ā | ||||||
Total Indirect | 30Ā % | Ā | ||||||
Malaria | 18Ā % | Ā | ||||||
HIV infection | 6Ā % | Ā | ||||||
Meningitis | 3Ā % | Ā | ||||||
Airede LR and Ekele BA (2003) [27] | Nigeria | Retrospective hospital based Study | 1990ā1999 | <19Ā years | 46 | Ā | <19Ā years | No comparison data available |
Eclampsia | 46Ā % | Ā | ||||||
Prolonged obstructed labour | 30Ā % | Ā | ||||||
Anaemia | 11Ā % | Ā | ||||||
Ruptured uterus | 7Ā % | Ā | ||||||
Postpartum haemorrhage | 4Ā % | Ā | ||||||
Abortion | 4Ā % | Ā | ||||||
Puerperal sepsis | 4Ā % | Ā | ||||||
Meningitis | 2Ā % | Ā | ||||||
Congestive cardiac failure | 2Ā % | Ā | ||||||
Sickle cell disease | 2Ā % | Ā | ||||||
Total is over 100Ā % as in some cases two independent causes were included) | ||||||||
Ujah I, Aisien O, Muthihir J, et al. (2005) [25] | Nigeria (Plateau State) | Prospective study using tertiary health facility data | 1991ā2001 | 10ā19 years | 25 | Ā | 10ā19 years | No comparison data available |
Total Direct | 76Ā % | Ā | ||||||
Abortion | 28Ā % | Ā | ||||||
Sepsis | 20Ā % | Ā | ||||||
Eclampsia | 20Ā % | Ā | ||||||
Haemorrhage | 8Ā % | Ā | ||||||
Total Indirect | 24Ā % | Ā | ||||||
Sickle cell anaemia | 8Ā % | Ā | ||||||
Other indirect causes | 16Ā % | Ā | ||||||
Okusanya B, Algere E, Abe A, Ibrahim H and Salawu R (2013) [26] | Nigeria (Katsina State) | Prospective study using maternal mortality database in tertiary health facility | 2008ā2012 | 15ā19 years | 16 | Ā | 15ā19 years | 15ā45 years |
Pre-eclampsia/eclampsia | 37.5Ā % | 18.9Ā % | ||||||
Obstructed labour/uterine rupture | 13Ā % | 6.8Ā % | ||||||
Puerperal sepsis | 13Ā % | 12.2Ā % | ||||||
Tetanus in puerperium | 13Ā % | 5.4Ā % | ||||||
Haemorrhage | 12Ā % | 21.6 | ||||||
Sickle cell anaemia | 6Ā % | N/A | ||||||
Anaemia | 6 % | 8.1 | ||||||
South East Asia | ||||||||
Fauveau V, Koenig MA, Chakraborty J, et al. (1988) [30] | Bangladesh (Matlab) | Data gathered from community based demographic surveillance system, with additional information gathered from health staff, health records and interviews with families | 1976ā1985 | 15-19 years | 78 adolescent deaths (originally 94 but 16 deaths from incidental causes removed and results recalculated) as a subsample of 387 deaths age 15ā45 years | Ā | 15ā19 years | 20ā34 years |
Total Direct | 88Ā % | 85Ā % | ||||||
Toxaemia/eclampsia | 22Ā % | 14Ā % | ||||||
Abortion | 20Ā % | 16Ā % | ||||||
Postpartum haemorrhage | 18Ā % | 21Ā % | ||||||
Other obstetric | 14Ā % | 18Ā % | ||||||
Obstructed labour | 7Ā % | 7Ā % | ||||||
Postpartum sepsis | 6Ā % | 8Ā % | ||||||
Concomitant | 12 % | 14 % | ||||||
Medical causes | 7Ā % | 7Ā % | ||||||
Unspecified | 5Ā % | 7Ā % | ||||||
Yusuf HR, Akhter HH, Chowdhury ME, Rochat RW (2007) [17] | Bangladesh | Data and health care provider interviews from 4751 health facilities in Bangladesh. | 1995/6 | 10ā19 years | 10ā19 1038 as a sub-sample of 8821 maternal deaths aged 10ā50 | Ā | 10ā19 years | 10ā50 years |
Total Direct | 89Ā % | 88Ā % | ||||||
Eclampsia | 47Ā % | 29Ā % | ||||||
Abortion-related causes | 12Ā % | 18Ā % | ||||||
PPH / APH | 10Ā % | 10Ā % | ||||||
Obstructed labour | 9Ā % | 14Ā % | ||||||
Retained placenta | 5Ā % | 8Ā % | ||||||
Other obstructed causes | 4Ā % | 7Ā % | ||||||
Tetanus | 2Ā % | 2Ā % | ||||||
Total Indirect | 11Ā % | 12Ā % | ||||||
Latin America and Caribbean/PAHO | ||||||||
Souza ML, Burgardt D, Ferreira LAP, Bub MBC, Monticelli M, Lentz HE (2010) [31] | Santa Catarina, Brazil | Retrospective population based study | 1994ā2005 | 10ā19 years | 58 (originally 64, but 6 deaths classified as āunrelatedā were removed and proportions recalculated) | Ā | 10ā19 years | No comparison data available |
Total Direct | 74Ā % | Ā | ||||||
Toxaemia | 29Ā % | Ā | ||||||
Infection | 17Ā % | Ā | ||||||
Haemorrhage | 16Ā % | Ā | ||||||
Other direct | 12Ā % | Ā | ||||||
Total Indirect | 26Ā % | Ā | ||||||
de SiqueiraĀ AAF, Tanaka ACd'A (1986) [32] | Brazil | Retrospective review of health records and official statistics | 1980 | 10ā19 years (10ā14 and 15ā19 years were presented separately but were amalgamated for this study due to small number of deaths in 12ā14 age group) | 306 (18 aged 10ā14 288 aged 15ā19 years) | Ā | 10ā19 years | No comparison data available |
Hypertensive disorders | 47Ā % | Ā | ||||||
Sepsis | 16Ā % | Ā | ||||||
Haemorrhage | 8Ā % | Ā | ||||||
Abortion | 6Ā % | Ā | ||||||
Embolism | 2Ā % | Ā | ||||||
Other pregnancy-related causes | 12Ā % | Ā | ||||||
Other | 7Ā % | Ā | ||||||
Donoso ES and Carvajal C (2012) [19] | Chile | Retrospective study of statistics from the yearbooks of Chileās National Institute of Statistics | 2000ā2009 | 15ā19 years | 36 as a sub-sample of 431 maternal deaths aged 15ā49 | Ā | 15ā19 years | 20ā49 years |
Hypertensive disorders | 44Ā % | 30Ā % | ||||||
Abortion | 18Ā % | 11Ā % | ||||||
Obstetric embolism | 6Ā % | 6Ā % | ||||||
Postpartum haemorrhage | 3Ā % | 6Ā % | ||||||
Puerperal sepsis | 3Ā % | 5Ā % | ||||||
Ectopic pregnancy | N/A | 7Ā % | ||||||
Concurrent illness | 28Ā % | 35Ā % | ||||||
Percentages were calculated based on births within each age groups and numbers of deaths by cause within each age group. | ||||||||
Acosta Chavez (2003) [33] | Peru | Retrospective from tertiary hospital | 1986ā2002 | Under 20Ā years | 30 | Ā | <20Ā years | No comparison data available |
Total Direct | 70Ā % | Ā | ||||||
Septic abortion | 33Ā % | Ā | ||||||
Infections | 17Ā % | Ā | ||||||
Haemorrhage | 13Ā % | Ā | ||||||
Toxaemia | 7Ā % | Ā | ||||||
Total Indirect | 30 % | Ā | ||||||
Pulmonary tuberculosis | 10 % | Ā | ||||||
Liver failure | 7Ā % | Ā | ||||||
Others | 13Ā % | Ā |