PDF(Pubmed)
Abstract：
BACKGROUND: Pregnancy and delivery deaths represent a risk to women, particularly those living in low- and middle-income countries (LMICs). This population-based survey was conducted to provide estimates of the maternal mortality ratio (MMR) in Lagos Nigeria.
METHODS: A community-based, cross-sectional study was conducted in mapped Wards and Enumeration Areas (EA) of all Local Government Areas (LGAs) in Lagos, among 9,986 women of reproductive age (15-49 years) from April to August 2022 using a 2-stage cluster sampling technique. A semi-structured, pre-tested questionnaire adapted from nationally representative surveys was administered using REDCap by trained field assistants for data collection on socio-demographics, reproductive health, fertility, and maternal mortality. Data were analysed using SPSS and MMR was estimated using the indirect sisterhood method. Ethical approval was obtained from the Lagos State University Teaching Hospital Health Research and Ethics Committee.
RESULTS: Most of the respondents (28.7%) were aged 25-29 years. Out of 546 deceased sisters reported, 120 (22%) died from maternal causes. Sisters of the deceased aged 20-24 reported almost half of the deaths (46.7%) as due to maternal causes, while those aged 45-49 reported the highest number of deceased sisters who died from other causes (90.2%). The total fertility rate (TFR) was calculated as 3.807, the Lifetime Risk (LTR) of maternal death was 0.0196 or 1-in-51, and the MMR was 430 per 100,000 [95% CI: 360-510].
CONCLUSIONS: Our findings show that the maternal mortality rate for Lagos remains unacceptable and has not changed significantly over time in actual terms. There is need to develop and intensify community-based intervention strategies, programs for private hospitals, monitor MMR trends, identify and contextually address barriers at all levels of maternal care.
METHODS: A community-based, cross-sectional study was conducted in mapped Wards and Enumeration Areas (EA) of all Local Government Areas (LGAs) in Lagos, among 9,986 women of reproductive age (15-49 years) from April to August 2022 using a 2-stage cluster sampling technique. A semi-structured, pre-tested questionnaire adapted from nationally representative surveys was administered using REDCap by trained field assistants for data collection on socio-demographics, reproductive health, fertility, and maternal mortality. Data were analysed using SPSS and MMR was estimated using the indirect sisterhood method. Ethical approval was obtained from the Lagos State University Teaching Hospital Health Research and Ethics Committee.
RESULTS: Most of the respondents (28.7%) were aged 25-29 years. Out of 546 deceased sisters reported, 120 (22%) died from maternal causes. Sisters of the deceased aged 20-24 reported almost half of the deaths (46.7%) as due to maternal causes, while those aged 45-49 reported the highest number of deceased sisters who died from other causes (90.2%). The total fertility rate (TFR) was calculated as 3.807, the Lifetime Risk (LTR) of maternal death was 0.0196 or 1-in-51, and the MMR was 430 per 100,000 [95% CI: 360-510].
CONCLUSIONS: Our findings show that the maternal mortality rate for Lagos remains unacceptable and has not changed significantly over time in actual terms. There is need to develop and intensify community-based intervention strategies, programs for private hospitals, monitor MMR trends, identify and contextually address barriers at all levels of maternal care.
摘要：
背景：妊娠和分娩死亡对妇女构成风险，特别是那些生活在低收入和中等收入国家（LMICs）。这项基于人口的调查旨在提供尼日利亚拉各斯孕产妇死亡率（MMR）的估计。
方法：以社区为基础，在拉各斯所有地方政府区域（LGA）的地图区和枚举区域（EA）进行了横断面研究，在2022年4月至8月的9,986名育龄妇女（15-49岁）中，使用2阶段整群抽样技术。半结构化，经培训的实地助理使用REDCap管理从全国代表性调查中改编的预测试问卷，以收集社会人口统计数据，生殖健康,生育力,和孕产妇死亡率。使用SPSS分析数据，并使用间接姐妹法估计MMR。从拉各斯州立大学教学医院健康研究和伦理委员会获得伦理批准。
结果：大多数受访者（28.7%）年龄在25-29岁之间。据报道，在546名已故姐妹中，120人（22%）死于母体原因。20-24岁死者的姐妹报告说，几乎一半的死亡（46.7％）是由于产妇原因，而45-49岁的死者因其他原因死亡的姐妹人数最多(90.2%)。总生育率（TFR）计算为3.807，孕产妇死亡的终身风险（LTR）为0.0196或1/51，MMR为430/100,000[95％CI：360-510]。
结论：我们的研究结果表明，拉各斯的孕产妇死亡率仍然是不可接受的，并且实际上并没有随着时间的推移而发生显著变化。有必要制定和加强以社区为基础的干预战略，私人医院的项目，监控MMR趋势，确定并根据具体情况解决各级孕产妇护理的障碍。
方法：以社区为基础，在拉各斯所有地方政府区域（LGA）的地图区和枚举区域（EA）进行了横断面研究，在2022年4月至8月的9,986名育龄妇女（15-49岁）中，使用2阶段整群抽样技术。半结构化，经培训的实地助理使用REDCap管理从全国代表性调查中改编的预测试问卷，以收集社会人口统计数据，生殖健康,生育力,和孕产妇死亡率。使用SPSS分析数据，并使用间接姐妹法估计MMR。从拉各斯州立大学教学医院健康研究和伦理委员会获得伦理批准。
结果：大多数受访者（28.7%）年龄在25-29岁之间。据报道，在546名已故姐妹中，120人（22%）死于母体原因。20-24岁死者的姐妹报告说，几乎一半的死亡（46.7％）是由于产妇原因，而45-49岁的死者因其他原因死亡的姐妹人数最多(90.2%)。总生育率（TFR）计算为3.807，孕产妇死亡的终身风险（LTR）为0.0196或1/51，MMR为430/100,000[95％CI：360-510]。
结论：我们的研究结果表明，拉各斯的孕产妇死亡率仍然是不可接受的，并且实际上并没有随着时间的推移而发生显著变化。有必要制定和加强以社区为基础的干预战略，私人医院的项目，监控MMR趋势，确定并根据具体情况解决各级孕产妇护理的障碍。
