Maternal mortality in Italy estimated by the Italian Obstetric Surveillance System

This study aimed to calculate Italy's first national maternal mortality ratio (MMR) through an innovative record-linkage approach within the enhanced Italian Obstetric Surveillance System (ItOSS). A record-linkage retrospective cohort study was conducted nationwide, encompassing all women aged 11-59 years with one or more hospitalizations related to pregnancy or pregnancy outcomes from 2011 to 2019. Maternal deaths were identified by integrating data from the Death Registry and national and regional Hospital Discharge Databases supported by the integration of findings from confidential enquiries conducted through active surveillance. Maternal Mortality Ratio (MMR), direct MMR (DMMR), and causes of maternal death are the study main outcomes. The MMR was found to be 8.4 per 100,000 live births (95% CI 7.5-9.3), significantly higher than the 3.9 per 100,000 (95% CI 3.3-4.5) calculated solely from the Death Registry, with a notable declining trend over the study period. Causes of death have been classified according to the 10th International Classification of Diseases. Within 42 days from pregnancy outcome, leading causes were obstetric haemorrhage, sepsis, and cardiovascular diseases. Late maternal deaths were primarily attributed to suicide, malignancies, and cardiovascular diseases. This integrated methodology provides a comprehensive understanding of maternal mortality trends and causes in Italy, offering valuable insights for countries utilizing or planning enhanced surveillance systems.

Authors

Institutions

Publication Details

Journal
Scientific Reports
Published
2024-12-30
DOI
https://doi.org/10.1038/s41598-024-80431-0
Citations
4
Primary Topic
Global Maternal and Child Health
Type
article
Field-Weighted Citation Impact
4.44

Funders

Controls
|||
ALL TIME
JAN
FEB
MAR
APR
MAY
JUN
JUL
AUG
SEP
OCT
article

Maternal mortality in Italy estimated by the Italian Obstetric Surveillance System

Paola D’Aloja, Roberta Giordana, Donatella Mandolini, Alice Maraschini et al.
4 citations
Scientific Reports
Global Maternal and Child Health
4.44
article

Maternal mortality in Italy estimated by the Italian Obstetric Surveillance System

Paola D’Aloja, Roberta Giordana, Donatella Mandolini, Alice Maraschini, Ilaria Lega, Michele Ercolanoni, Raffaella Rusciani, Giovanni Baglìo, Serena Donati, Anna Maria Nannavecchia, Riccardo Pertile, Gabriella Dardanoni, Giada Minelli, Sergio Battaglia, Marco Pompili, Manuela Giangreco, Eliana Ferroni, Edoardo Corsi Decenti, Monia Puglia, Antonello Antonelli, Eva Papa, Arianna Polo, Valentina Domeneghetti, Barbara Gamboni
article en
4 citations

Abstract

This study aimed to calculate Italy's first national maternal mortality ratio (MMR) through an innovative record-linkage approach within the enhanced Italian Obstetric Surveillance System (ItOSS). A record-linkage retrospective cohort study was conducted nationwide, encompassing all women aged 11-59 years with one or more hospitalizations related to pregnancy or pregnancy outcomes from 2011 to 2019. Maternal deaths were identified by integrating data from the Death Registry and national and regional Hospital Discharge Databases supported by the integration of findings from confidential enquiries conducted through active surveillance. Maternal Mortality Ratio (MMR), direct MMR (DMMR), and causes of maternal death are the study main outcomes. The MMR was found to be 8.4 per 100,000 live births (95% CI 7.5-9.3), significantly higher than the 3.9 per 100,000 (95% CI 3.3-4.5) calculated solely from the Death Registry, with a notable declining trend over the study period. Causes of death have been classified according to the 10th International Classification of Diseases. Within 42 days from pregnancy outcome, leading causes were obstetric haemorrhage, sepsis, and cardiovascular diseases. Late maternal deaths were primarily attributed to suicide, malignancies, and cardiovascular diseases. This integrated methodology provides a comprehensive understanding of maternal mortality trends and causes in Italy, offering valuable insights for countries utilizing or planning enhanced surveillance systems.

Scientific ReportsVol. 14(1)
Agenzia Regionale per la Protezione Ambientale del Piemonte (IT), Istituto Superiore di Sanità (IT), IRCCS Materno Infantile Burlo Garofolo (IT), Regione Campania (IT), ASL Roma (IT), Provincia Autonoma di Trento (IT), Agenzia Regionale Sanitaria della Puglia (IT), Regione Siciliana (IT), Agenzia Regionale Prevenzione e Ambiente della Regione Emilia-Romagna (IT), Regione del Veneto (IT), Osservatorio Astronomico della Regione Autonoma Valle d'Aosta (IT), Progemisa (IT), Servizio Sanitario Nazionale (IT), Lombardia Informatica (Italy) (IT), Regione Autonoma della Sardegna
Ministero della Salute
Good health and well-being
Openalex Percentile: Top 6%
Global Maternal and Child Health
4.44
DOIOpen Access PDFOpenAlex
AI Navigator

Ask Laika to Summarize, Analyze, and Connect papers live on the map.

Summarize Papers & Methodologies

Extract key findings, datasets, and comparative methods across publications.

Benchmark Rankings & Visual Analytics

Rank top research institutions, authors, funders, topics, and journals by Field-Weighted Citation Impact (FWCI) and paper volume with instant charts.

Connect Distant Disciplines

Bridge topological clusters on the map to find hidden collaborative intersections.