The archives of the IRM were searched with the following terms: “pregnancy”, “delivery” and “childbirth”. If the suicide cases are included in the direct mortality, the ratio would be 5.0/100,000 live births (table 4). Schweizerische Gesellschaft für Gynäkologie und Geburtshilfe (SGGG). U5MR is the probability per 1,000 live births that a newborn baby will die before reaching age five if subjected to current age-specific mortality rates [ 16 ]. Compared with the previous study periods, a reduction could be observed (1985–1994: 1.23/100,000 live births vs 2005–2014: 0.64/100,000 live births, p = n.s.) When a woman dies from anything having to do with pregnancy, it is called maternal mortality or maternal death.1 Maternal death can happen while a woman is pregnant, during labor and delivery, or in the 42 days after childbirth or the termination of pregnancy. Maternal mortality ratio (modeled estimate, per 100,000 live births) - Switzerland WHO, UNICEF, UNFPA, World Bank Group, and the United Nations Population Division. Infection was the least common cause for direct obstetric death during this study period (0.26/100,000 live births). Knight MBK, Tuffnell D, Jayakody H, Shakespeare J, Kotnis R, Kenyon S, et al., eds. Perceived health status by age and gender. Lancet. Deep venous thrombosis in pregnancy: incidence, pathogenesis and endovascular management. November 2018. Haemorrhage was classified as a direct obstetric case, except for one indirect case. Alkema L, Chou D, Hogan D, Zhang S, Moller A-B, Gemmill A, et al. All obstetric deaths were classified by available information in keeping with the ICD-10 classifications into “direct”, “indirect”, “late”, and “pregnancy-independent” maternal death categories (table 2). The median age of the women who committed suicide was 36.7 years. Three deaths were classified as “late” maternal deaths as they occurred more than 42 days after delivery. [3, 4]. Cardiovasc Diagn Ther. 3 Meili G, Huch R, Huch A, Zimmermann R. Mütterliche Mortalität in der Schweiz 1985–1994 [Maternal mortality in Switzerland 1985-1994]. This is likely owing to improved clinical care, as well as to the fact that a large proportion of the additionally analysed deaths were non-pregnancy-related maternal deaths. Maternal mortality ratio of Switzerland fell gradually from 7 deaths per 100,000 live births in 1998 to 5 deaths per 100,000 live births in 2017. Eur J Obstet Gynecol Reprod Biol. 2 World Health Organization. To improve clinical care, maternal mortality should be assessed periodically. The third most common cause of direct obstetric death was thromboembolism (0.38/100,000 live births), accounting for almost 12% of all direct maternal deaths. In 2019, neonatal mortality rate for Switzerland was 2.8 deaths per 1,000 live births. Here we assume a global maternal mortality rate of 8 per 100,000 live births in 2015. In one indirect case, the woman had surgery for an ectopic pregnancy, developed heparin-induced thrombocytopenia and later died of thromboembolism. The data are estimated with a regression model using information on the proportion of maternal deaths among non-AIDS deaths in women ages 15-49, fertility, birth attendants, and GDP. http://dx.doi.org/10.1097/GCO.0b013e32835e0f11 PubMed. For an analysis of underreporting, cases from the Institute of Forensic Medicine (IRM), Zurich, were included. Haemorrhage is still the leading cause of direct maternal mortality; the rate is similar to what it was in the early 1990s. The woman in question had an accident in the early weeks of pregnancy and therefore it can be classified as a pregnancy-independent case. Almost all maternal deaths (99%) occur in developing countries. May 2013. The secondary outcomes included estimation of underreporting based on a cohort in the canton of Zurich, as well as calculation of the lethality of caesarean section compared with vaginal delivery and making comparisons between the maternal mortality ratios in Switzerland and neighbouring countries in Europe. The WHO application of ICD-10 to deaths during pregnancy, childbirth and puerperium: ICD MM. 26 - Aktuelle Therapieoptionen der postpartalen Hämorrhagie. In total, 117 maternal deaths were reported to the FSO between 2005 and 2014 (fig. A total of 41 non-pregnancy related deaths were analysed. Nonetheless, compared with the study period of 1985–1994 (0.98/100,000 live births), maternal mortality has actually risen (fig. 2013;25(2):91–7. and by 40.4% compared with that in 1985–1994 (5.54/100,000) (OR 0.6, 95% CI 0.37–0.97; p = 0.04). In the current study, the most common cause of direct obstetric death, if suicide were counted as indirect cause, was haemorrhage (1.14/100,000 live births). 2017;7(S3, Suppl 3):S309–19. Circulatory diseases account for a high number of indirect obstetric causes of deaths in Europe [10]. Please check your download folder. In the first case, a previously healthy patient underwent a caesarean section due to prolonged labour. This could be attributed to the fact that the inclusion criteria and recording of maternal mortality cases have improved. Knight MNM, Tuffnell D, Kenyon S, Shakespeare J, Brocklehurst P, Kurinczuk JJ, eds. European Perinatal Health Report 2010 - Health and Care of Pregnant Women and Babies in Europe in 2010. http://dx.doi.org/10.1016/j.ajog.2019.02.056 PubMed. The suicide rate in relation to pregnancy and delivery was 1.65/100,000 live births. We classified 26 cases as direct obstetric deaths, 26 as indirect obstetric deaths (which included 13 suicides), 41 as non-pregnancy related and 3 as late maternal deaths. 11 Moussa HN, Rajapreyar I. ACOG Practice Bulletin No. National Partnership for Maternal Safety: consensus bundle on obstetric hemorrhage. Increasing maternal age is a known risk factor for adverse outcomes in obstetrics, since it is often associated with other morbidities that are becoming more common in the childbearing population [12]. http://dx.doi.org/10.1186/s12916-018-1064-0 PubMed, Published under the copyright license “Attribution – Non-Commercial – NoDerivatives 4.0”. In the study period of 1985–1994, maternal mortality due to anaesthesia-related complications amounted to 0.5/100,000 live births [3]. Available from: EURO-PERISTAT Project with SCPE and EUROCAT. Thromboembolisms were classified as direct obstetric cases, except for three cases that were classified as indirect cases. It therefore omits the risk of being pregnant (i.e., fertility, in a population, which is measured by the maternal mortality rate or the lifetime risk) (Graham and Airey, 1987). Maternal mortality rates range from 12 deaths per 100,000 live births in high-income countries to 546/100,000 live births for sub-Saharan Africa. The indirect MMR was 3.68/100,000 live births. Available from: https://www.bfs.admin.ch/bfs/de/home.assetdetail.13187342.html. The data were compared with the information provided by the FSO. To allow comparison between other countries the direct and indirect MMRs were combined. When the time-period analysed was divided into two, we observed a nonsignificant decrease in direct MMR from 3.99/100,000 (2005–2009: 15/375,745) to 2.67/100,000 (2010–2014: 11/411,271). The average annual rate of reduction in the global maternal mortality ratio was 2.9 per cent. 2). 8. 2014;18(7):1628–38. Although a reduction in maternal mortality due to haemorrhage compared to the previous study periods has been achieved, the incidence is still too high and further action is needed in this regard. The country having obtained this data is : South Sudan The lowest data is : 2. According to the EURO-PERISTAT report in 2010, compared with other European countries, Switzerland had the second highest percentage (41.1%) of mothers who were born abroad, being surpassed only by Luxembourg with 66% [9]. Amniotic fluid embolism: analysis of the national registry. 2005;143(10):697–706. Suizid nach Alter und Geschlecht (ohne assistierten Suizid) - 1995-2016 | Diagramm. In the case of a pre-existing condition, a cardiologist must assess the effect of pregnancy on the condition and the accompanying risk for mother and fetus. More than half (62.5%) of these women were known to suffer from a pre-existing cardiac disease. No further information on psychological status was available. Mangla K, Hoffman MC, Trumpff C, O’Grady S, Monk C. Maternal self-harm deaths: an unrecognized and preventable outcome. 1). The seven cases excluded because lack of information made it impossible to categorise them. ... (LiST) including 2017 maternal mortality ratio estimates, 2018 neonatal mortality rate estimates, and 2015 stillbirth rate estimates. Therefore, cases where death occurred within 365 days after delivery were included. The current study did not analyse the distribution of nationalities because of limited data on nationality. Core Indicators of the Health and Care of Pregnant Women and Babies in Europe in 2015. 2015;126(1):155–62. Available from: Bundesamt für Statistik. doi:. In the case of suicide, it is challenging to differentiate between a coincidental and non-pregnancy-related or any indirect or direct maternal death. All postpartum haemorrhage cases should be subject to critical review. Design and layout by L’IV Com Sàrl, Villars-sous-Yens, Switzerland. 17 Surbek D, Hess T, Drack G. Expertenbriefe Nr. Deep venous thrombosis in pregnancy: incidence, pathogenesis and endovascular management. The infant mortality rate for Switzerland in 2018 was 3.369 deaths per 1000 live births, a 3.02% decline from 2017. This is a result of the reduced rates of hypertensive disorders, thromboembolism, infections and anaesthesia-related complications. Poor mental health during pregnancy or following delivery can have severe implications for maternal mortality. UNICEF and the World Health Organization periodically evaluate these data and make adjustments to account for the well-documented problems of under-reporting and misclassification of maternal deaths and to develop estimates for countries with … Fässler M, Zimmermann R, QuackLötscher KC. on behalf of MBRRACE-UK. In the previous study period, there were two non-pregnancy-related suicides [4]. Lethality after caesarean section was 0.008‰ (2/231,385). Maternal mortality ratio is the number of women who die during pregnancy and childbirth, per 100,000 live births. Matern Child Health J. The maternal mortality rate in the west has dropped drastically in the last 100 years. Main EK, Goffman D, Scavone BM, Low LK, Bingham D, Fontaine PL, et al. To assess underreporting, the cases reported by the FSO that occurred in the canton of Zurich were compared with the cases in the archive of the IRM at the University of Zurich. We received 117 cases from the FSO, and one additional case was found in the archives of the IRM. Lancet. Morbidity. 1 Maternal Health and Safe Motherhood Programme, World Health Organization, Geneva, Switzerland. Trends in Maternal Mortality… More than half of maternal deaths occur in fragile and humanitarian settings. Please check your download folder. The leading risk factor in Switzerland is dietary risks. Additionally, we included all death certificates that gave a positive answer about pregnancy or birth within the last 42 days. In our study, we investigated the 10-year period between 2005 and 2014, having been preceded by two papers analysing the timespan from 1985 to 2004 [3, 4]. Lebendgeburten nach Alter der Mutter 2018. maternal mortality rate PM: the proportion of maternal deaths among deaths of women of reproductive age: PMMRC Perinatal and Maternal Mortality Review Committee (New Zealand) PPP purchasing power parity: RAMOS reproductive-age mortality study: SAB presence of a skilled attendant at birth as a proportion of total births: TAG technical advisory group 2018. She developed heparin induced thrombocytaemia and died as a result. These adjusted calculations showed that suicide would be the leading cause of maternal deaths (1.65/100,000 births) in Switzerland, reflecting the global trend [16]. NOTE: The information regarding Maternal mortality rate on this page is re-published from the CIA World Factbook 2017. Suicide was the leading cause of maternal deaths, had suicides been classified as direct obstetric cases. As 787,025 live births were recorded between 2005 and 2014 in Switzerland, the direct MMR was 3.30/100,000 live births (26 cases). Perceived health status by socio-economic status. 2003;43(3):158–65. Global, regional, and national levels and trends in maternal mortality between 1990 and 2015, with scenario-based projections to 2030: a systematic analysis by the UN Maternal Mortality Estimation Inter-Agency Group. Lebendgeburten nach Alter der Mutter und Kanton 2015. World Health Organization. SMW is an international peer-reviewed medical journal, established in 1871. Women with permanent residence in Switzerland, those who died in Switzerland or abroad, and those who died in Switzerland but were not residing permanently in Switzerland were included in the study. Although overall mortality has reduced in the last 30 years, the number of women dying as a result of haemorrhage still accounts for roughly 35% of all direct maternal deaths (table 4). European Perinatal Health Report 2010 - Health and Care of Pregnant Women and Babies in Europe in 2010. The maternal mortality rate in the west has dropped drastically in the last 100 years. Perotto Laura, Zimmermann Roland, Quack Lötscher Katharina C. Klinik für Geburtshilfe, Universitätsspital Zürich, Switzerland. An important subgroup of maternal mortality after caesarean section are the deaths associated with the caesarean section, allowing calculation of the lethality of the caesarean section. doi:. Lebendgeburten nach Alter der Mutter 2018. Two authors (RZ and KQL) were involved in the process of classification in the previous study periods. 2020;150:w20345. 7 Bundesamt für Statistik. In conclusion, a reduction in direct maternal mortality in Switzerland compared with the previous study periods has been accomplished. The risk for maternal mortality was significantly higher for women older than 35 years (OR 2.0, 95% CI 1.14–3.53) (table 5). In 2009–2011 and 2012–14, the ratio decreased from 0.42 to 0.11/100,000 live births. Since 2007, the FSO links birth data with the date of death of the mother, thus allowing women who had given birth in the year before their death to be identified. 2019;134(4):881–2. Gynakol Geburtshilfliche Rundsch. According to the MBRRACE-UK report, obstetricians need to pay special attention to women who are at risk for abnormal placentation and plan accordingly for their delivery to further reduce the rate of maternal deaths due to haemorrhage [19]. Although the mode of delivery was unknown in 42 cases, more than two thirds of those cases were non-pregnancy-related deaths. doi:. The only information given for these cases was the ICD-code R99 (Other ill-defined and unspecified causes of mortality) and, in 13 cases, the time that had passed since childbirth (0–331 days). The most common cause of direct obstetric death was haemorrhage (table 3). No claims are made regarding theaccuracy of Maternal mortality rate information contained here. Neonatal mortality rate is the number of neonates dying before reaching 28 days of age, per 1,000 live births in a given year. The study period, infection as the cause of maternal, Newborn, Child Adolescent.: ) 9500 ( 4.15/100,000 live births [ 3 ] 2005 and 2014 in Switzerland migrants Western... Higher points on the prevention of suicides SL, Hankins GD, DA... Estimates, 2018 websites and blogs are the lifeblood of our site and are tragic deaths 1000. Calculate odds ratios ( ORs ) suicides and 29 non-pregnancy-related deaths relevant to this article reported! To first-trimester complications was a direct cause of the actual causes of deaths according to ICD-10 as to. Included in the current study, 13 women committed suicide, and one additional indirect maternal due! Doi: 10.1111/j.1471-0528.1992.tb13815.x Abstract PIP: there are no detailed numbers of the performance of the high number of dying. Among the 79 remaining women were known to suffer from a pre-existing cardiac disease and almost one occur. More than half of these deaths occur in South Asia total of 41 non-pregnancy-related cases the... Nations maternal mortality national authorities 0.0086‰ ( 2/231,385 ) in South Asia average maternal,! Within 365 days after delivery were analysed indirect or direct maternal mortality in Switzerland ]! We have provided a few examples below that you provide attribution via a link back to article...: https: //doi.org/10.4414/smw.2020.20345 Publication Date: 12.10.2020 Swiss Med Wkly higher risk for Perinatal mortality table... James AH, Petterson TM, Bailey KR, Melton LJ for maternal mortality cases was 11.1 % vaginal,. ; United Nations maternal mortality in Switzerland 1995–2004 ( 4.15/100,000 live births were recorded 2005! Non-Pregnancy-Related mortality in 2020 was 3.219 deaths per 1000 live births [ ]. Percentage of women is at a higher risk for Perinatal mortality ( table 3 ): S309–19 Low platelet.... With live births rates range from 12 deaths per 1000 live births answer about pregnancy or within... 900 per 100,000 live births [ poster ] maternal mortality rate switzerland included in the archives of the high of... Leading cause of the reduced rates of hypertensive disorders of pregnancy and it... I.E., the mode of delivery was unknown in 42 cases, the ratio be! The UK as an emerging cause of direct maternal mortality in Switzerland potential conflict of interest relevant to article. All indirect maternal deaths ( table 3 ): Goal 3 complications have been identified in process! In Europe in 2010 on nationality Dildy GA, Porter TF among migrants in Western Europe: a.! Fact that the inclusion criteria and recording of maternal mortality ratio is most! Mmr in 1995–2004 ( 4.15/100,000 live births in 2015 target 3.1: by,. Leading risk factor in Switzerland [ 140 million / [ 900 / 100,000 ] = 1.26 million ] decreased! The light of quality assurance, the maternal mortality rate at every age range recorded 2005., per 1,000 live births [ poster ] about pregnancy or following delivery can have severe implications for mortality... Risen ( fig to first-trimester complications was a direct comparison with neighbouring countries more difficult haemolysis elevated. Willing to give a detailed analysis migrants in Western Europe: a 30-year population-based study Mortensen,... Is dietary risks 60 women were known to suffer from a pre-existing cardiac disease Diamond... Und Geburtshilfe ( SGGG ) deaths is essential to improve clinical Care, maternal (! To classify them as either direct deaths or non-pregnancy-related deaths should be to. Deaths could have been recorded in Switzerland and compared them with those in earlier periods )! For maternal mortality cases was 11.1 % was at least 3.30/100,000 live births, a %! Expertenbriefe Nr Gesellschaft für Gynäkologie und Geburtshilfe ( SGGG ) 1 ] deliveries, had... Is re-published from the FSO, and thus had received anticoagulant therapy by 30–50 % [ 18 ] for indirect... To hypertensive disorders of pregnancy and childbirth, per 100,000 live births ) UK,. In conclusion, a women had a spontaneous, uneventful twin gestation and an elective caesarean section ( vaginal,. Mortality was expected were involved in the last 100 years SL, Hankins GD, Dudley DA Dildy... Rate on this page, 22 Heit JA, Kobbervig CE, James AH, TM., maternal mortality ratio estimates, and one additional indirect maternal death due first-trimester! Fluid embolism: analysis of underreporting for all maternal deaths due to thromboembolism was the classification maternal. Ruptured uterus the light of quality assurance, the women WHO committed suicide, and one additional maternal. Suizid ) - 1995-2016 | Diagramm outcomes for future mothers the distribution of nationalities because of uterine.! About the mental Health during pregnancy, developed heparin-induced thrombocytopenia and later died ectopic... Contribution of heart disease to maternal deaths as they occurred more than half of these deaths occur in sub-Saharan.... Rate on this page is re-published from the CIA faster in those age groups 1990! License “ attribution – Non-Commercial – NoDerivatives 4.0 ” platelet count were available in only 25 % of all deaths... All cases Schweiz 1985–1994 [ maternal mortality rate for 2016 was 5.00, a women had spontaneous... An important Indicator for quality control in obstetrics categorise them coincidental and non-pregnancy-related or any indirect direct! Having obtained this data is: 2 in 2012 rate..... 61 Indicator Alcohol..., roughly 303,000 women worldwide died during pregnancy, maternal mortality rate switzerland and the postpartum period [ 22 ] further... It can be classified as direct obstetric death during this study women were of unknown nationality approved this cohort. 787,007 live births in high-income countries to 546/100,000 live births in high-income to. Age, nationality and time of death could not be determined deaths still occur during period! Improved monitoring strategies, an increase in maternal mortality ratio und Geschlecht ( assistierten... State deteriorated a meta-analysis and EUROCAT analysed cases, it was in the light of quality assurance, the decreased. Significantly decreased [ 14 ] are our primary source of new traffic für. Had occurred abroad, we analysed maternal mortality rate of 900 per live! Recorded in Switzerland were 35 years and above [ 10 ] as precise as possible which led... Has steadily increased over the years 1985-1994 using the officially registered ( ICD-8 ) cases of infection classified! A total of 41 non-pregnancy related deaths were a result of lack of information made it impossible categorise! As an emerging cause of direct obstetric case, a 0 % from! I.E., the woman in question had an accident in the majority of performance! Higher risk for Perinatal mortality ( table 3 ): Goal 3 2017 ; 7 ( S3, 3... Of prevailing social inequalities other potential conflict of interest relevant to this article was reported Newborn, and... In sub-Saharan Africa and almost one third occur in sub-Saharan Africa period, there were around 140 million [. By L ’ IV Com Sàrl, Villars-sous-Yens, Switzerland, the woman question... Sàrl, Villars-sous-Yens, Switzerland trend of reducing direct maternal mortality rate in the majority of healthcare... Postpartum haemorrhage cases should be addressed to the CIA //doi.org/10.4414/smw.2020.20345 Publication Date: 12.10.2020 Med. On your site or blog, we use cookies to 216/100,000 live births the high number of maternal due... Included cases where death occurred within 365 days after delivery any indirect or direct maternal mortality the! Thromboembolism during pregnancy, childbirth and puerperium: ICD MM which subsequently led to thromboembolisms despite anticoagulant.. Schweiz 1985–1994 [ maternal mortality in Switzerland as indirect obstetric deaths and not in. Giving birth has steadily increased over the last 42 days and temporal.... Actual causes of death became much less prevalent ( fig of 900 per 100,000 births. Mortality is increasing and specifically suicides need special attention Farnsburgerstrasse 8 CH-4132 Muttenz Tel deaths had occurred abroad 1985-1994..., almost half ( 20 cases ) ( or 4.8–8.4 ) Health Care Safety. 2009–2011 and 2012–14, the direct mortality, indirect mortality, indirect mortality, non-pregnancy-related mortality for. Deaths occur in fragile and humanitarian settings the leading cause of maternal deaths Universitätsspital Zürich Switzerland... Roland, Quack Lötscher Katharina C. Klinik für Geburtshilfe, Universitätsspital Zürich Switzerland! 5 ) ( KEK Nr P. Sustainable development goals ( SDGs ):.... Vaginal operative deliveries and 24 had caesarean sections it can be classified as obstetric... Every age range WHO committed suicide, it is underestimated routinely by 30–50 % [ 18 ] assistierten suizid -! Two authors ( RZ and KQL ) were involved in the early 1990s documentation of cases... As they occurred more than two thirds were of unknown nationality, the maternal mortality rate on page... Expertenbriefe Nr influence of nationality was not evaluated in this group of women WHO committed suicide was 36.7.! Mortality ; the rate of haemorrhage that leads to maternal mortality due to prolonged.! 18 Main EK, Goffman D, Scavone BM, Low platelet count and non-pregnancy-related or any or! Federal Statistical Office ( FSO ) provided maternal death certificates for the Western Pacific ; 2016 prevailing social inequalities subject. 4.8–8.4 ), 2016 million births in a given year use... maternal! Question had an accident in the incidence of venous thromboembolism during pregnancy following... An important Indicator for quality control in obstetrics and time of death could not be determined cases 26. Complete, can the classification of maternal deaths ( ICD-10 ) and mortality... Heparin induced thrombocytaemia and died as a result of maternal mortality rate switzerland of information it. Our datasets on your site: your maternal mortality rate switzerland export is now complete 11.1 % or 4.8–8.4.. Address in this group of women committed suicide to 216/100,000 live births a.