Global, regional, and national levels and causes of maternal mortality during 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013.

Autor:	Kassebaum NJ; Institute for Health Metrics and Evaluation, Seattle, WA, USA; Pediatric Anesthesiology and Pain Medicine, Seattle Children's Hospital, School of Medicine, Seattle, WA, USA. Electronic address: nickjk@uw.edu., Bertozzi-Villa A; Institute for Health Metrics and Evaluation, Seattle, WA, USA., Coggeshall MS; Institute for Health Metrics and Evaluation, Seattle, WA, USA., Shackelford KA; Institute for Health Metrics and Evaluation, Seattle, WA, USA., Steiner C; Institute for Health Metrics and Evaluation, Seattle, WA, USA., Heuton KR; Institute for Health Metrics and Evaluation, Seattle, WA, USA., Gonzalez-Medina D; Institute for Health Metrics and Evaluation, Seattle, WA, USA., Barber R; Institute for Health Metrics and Evaluation, Seattle, WA, USA., Huynh C; Institute for Health Metrics and Evaluation, Seattle, WA, USA., Dicker D; Institute for Health Metrics and Evaluation, Seattle, WA, USA., Templin T; Institute for Health Metrics and Evaluation, Seattle, WA, USA., Wolock TM; Institute for Health Metrics and Evaluation, Seattle, WA, USA., Ozgoren AA; Hacettepe University Institute of Population Studies, Ankara, Turkey., Abd-Allah F; Faculty of Medicine, Cairo University, Cairo, Egypt., Abera SF; School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Tigray, Ethiopia., Abubakar I; University College London, London, UK., Achoki T; Ministry of Health, Gaborone, Botswana., Adelekan A; Public Health Promotion Alliance, Osogbp, Nigeria., Ademi Z; University of Melbourne, Melbourne, VIC, Australia., Adou AK; Association Ivoirienne Pour Le Bien Etre Familial, Abidjan, Côte d'Ivoire., Adsuar JC; University of Extremadura, Cáceres, Spain., Agardh EE; Institution of Public Health Sciences, Stockholm, Sweden., Akena D; Makerere University, Kampala, Uganda., Alasfoor D; Ministry of Health, Muscat, Oman., Alemu ZA; Debre Markos University, Debre Markos, Amhara, Ethiopia., Alfonso-Cristancho R; University of Washington, Seattle, WA, USA., Alhabib S; National Guard Health Affairs, Riyadh, Saudi Arabia., Ali R; University of Oxford, Oxford, UK., Al Kahbouri MJ; Ministry of Health, Muscat, Oman., Alla F; School of Public Health, University of Lorraine, Nancy, France., Allen PJ; Ministry of Health, Belmopan, Cayo, Belize., AlMazroa MA; Saudi Ministry of Health, Riyadh, Saudi Arabia., Alsharif U; Charité Universitätsmedizin Berlin, Berlin, Germany., Alvarez E; Spanish Observatory on Drugs, Government Delegation for the National Plan on Drugs, Madrid, Spain; Ministry of Health, Social Services and Equality, Madrid, Spain., Alvis-Guzmán N; Universidad de Cartagena, Cartagena de Indias, Colombia., Amankwaa AA; Albany State University, Albany, GA, USA., Amare AT; Department of Epidemiology, University of Groningen, Groningen, Netherlands; College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia., Amini H; Kurdistan Environmental Health Research Centre, Kurdistan University of Medical Sciences, Sanandaj, Kurdistan, Iran., Ammar W; Ministry of Public Health, Beirut, Lebanon., Antonio CA; College of Public Health, University of the Philippines Manila, Manila, Philippines., Anwari P; UN Population Fund, Kabul, Afghanistan., Arnlöv J; Uppsala University, Uppsala, Sweden., Arsenijevic VS; Institute of Microbiology and Immunology, School of Medicine, University of Belgrade, Belgrade, Serbia., Artaman A; Median, Windsor, ON, Canada., Asad MM; Ministry of Health, Amman, Jordan., Asghar RJ; Field Epidemiology and Laboratory Training Program, Islamabad, Pakistan., Assadi R; Mashhad University of Medical Sciences, Mashhad, Iran., Atkins LS; Ministry Of Health, Wellness, Human Services and Gender Relations, Sans Souci, Castries, Saint Lucia., Badawi A; Public Health Agency of Canada, Toronto, ON, Canada., Balakrishnan K; Sri Ramachandra University, Chennai, India., Basu A; School of Health Sciences, University of Canterbury, Christchurch, New Zealand., Basu S; Stanford University, Stanford, CA, USA., Beardsley J; Oxford University, Ho Chi Minh City, Vietnam., Bedi N; College of Public Health and Tropical Medicine, Jazan, Saudi Arabia., Bekele T; Madawalabu University, Bale Goba, Oromia, Ethiopia., Bell ML; Yale University, New Haven, CT, USA., Bernabe E; King's College London, London, UK., Beyene TJ; Addis Ababa University, Debre Zeit, Ethiopia., Bhutta Z; Aga Khan University Medical Centre, Karachi, Pakistan., Bin Abdulhak A; University of Missouri-Kansas City, Kansas City, MO, USA., Blore JD; University of Melbourne, Melbourne, VIC, Australia., Basara BB; General Directorate of Health Research, Ankara, Turkey., Bose D; World Bank, Washington, DC, USA., Breitborde N; University of Arizona, Tucson, AZ, USA., Cárdenas R; Universidad Autonoma Metropolitana, Mexico City, Mexico., Castañeda-Orjuela CA; Colombian National Health Observatory, Instituto Nacional de Salud, Bogota, Colombia., Castro RE; Universidad Diego Portales, Santiago, Chile., Catalá-López F; Division of Pharmacoepidemiology and Pharmacovigilance, Spanish Medicines and Healthcare Products Agency, Madrid, Spain., Cavlin A; Hacettepe University Institute of Population Studies, Ankara, Turkey., Chang JC; National Taiwan University, Taipei, Taiwan., Che X; National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA., Christophi CA; Cyprus University of Technology, Limassol, Cyprus., Chugh SS; Cedars-Sinai Medical Centre, Los Angeles, CA, USA., Cirillo M; University of Salerno, Baronissi, Italy., Colquhoun SM; Centre for International Child Health, Melbourne, VIC, Australia., Cooper LT; Mayo Clinic, Rochester, MN, USA., Cooper C; Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK., da Costa Leite I; National School of Public Health (ENSP/Fiocruz), Rio de Janeiro, Brazil., Dandona L; Institute for Health Metrics and Evaluation, Seattle, WA, USA; Public Health Foundation of India, New Delhi, India., Dandona R; Public Health Foundation of India, New Delhi, India., Davis A; Public Health England, London, UK., Dayama A; School of Medicine, Atlanta, GA, USA., Degenhardt L; University of New South Wales, Sydney, NSW, Australia., De Leo D; Griffith University, Brisbane, QLD, Australia., del Pozo-Cruz B; University of Auckland, Auckland, New Zealand., Deribe K; Addis Ababa University, Debre Zeit, Ethiopia., Dessalegn M; Africa Medical and Research Foundation in Ethiopia, Addis Ababa, Ethiopia., deVeber GA; Hospital for Sick Children, University of Toronto, Toronto, ON, Canada., Dharmaratne SD; University of Peradeniya, Peradeniya, Sri Lanka., Dilmen U; General Directorate of Health Research, Ankara, Turkey., Ding EL; Harvard School of Public Health, Boston, MA, USA., Dorrington RE; University of Cape Town, Cape Town, South Africa., Driscoll TR; Sydney School of Public Health, NSW, Australia., Ermakov SP; The Institute of Social and Economic Studies of Population at the Russian Academy of Sciences, Moscow, Russia., Esteghamati A; Endocrinology and Metabolism Research Centre, Tehran University of Medical Sciences, Tehran, Iran., Faraon EJ; College of Public Health, University of the Philippines Manila, Manila, Philippines., Farzadfar F; Non-Communicable Diseases Research Centre, Tehran University of Medical Sciences, Tehran, Iran., Felicio MM; Departamento de Saúde Pública, ARS Norte IP, Porto, Portugal., Fereshtehnejad SM; Karolinska Institutet, Stockholm, Sweden., de Lima GM; Public Health Department, Unidade Local de Saúde de Matosinhos, Porto, Portugal., Forouzanfar MH; Institute for Health Metrics and Evaluation, Seattle, WA, USA., França EB; Federal University of Minas Gerais, Belo Horizonte, Brazil., Gaffikin L; School of Medicine, Stanford, CA, USA., Gambashidze K; National Centre for Disease Control and Public Health of Georgia, Tbilisi, Georgia., Gankpé FG; Clinique Coopérative de Parakou, Parakou, Borgou, Benin., Garcia AC; Public Health Unit of Primary Health Care Group of Almada-Seixal, Almada, Setúbal, Portugal., Geleijnse JM; Division of Human Nutrition, Wageningen University, Wageningen, Netherlands., Gibney KB; Monash University, Melbourne, VIC, Australia., Giroud M; University Hospital of Dijon, Dijon, France., Glaser EL; Heller School for Social Policy and Management, Waltham, MA, USA., Goginashvili K; Ministry of Labour, Health and Social Affairs, Tbilisi, Georgia., Gona P; University of Massachusetts Medical School, Worcester, MA, USA., González-Castell D; National Institute of Public Health, Cuernavaca, Mexico., Goto A; Department of Diabetes Research, National Centre for Global Health and Medicine, Tokyo, Japan., Gouda HN; University of Queensland, Brisbane, QLD, Australia., Gugnani HC; Saint James School of Medicine, Kralendijk, Bonaire, Netherlands., Gupta R; Kanawha Charleston Health Department, Charleston, WV, USA., Gupta R; Fortis Escorts Hospital, Jaipur, India., Hafezi-Nejad N; Endocrinology and Metabolism Research Centre, Tehran University of Medical Sciences, Tehran, Iran., Hamadeh RR; Arabian Gulf University, Manama, Bahrain., Hammami M; Wayne County Department of Health and Human Services, Detroit, MI, USA., Hankey GJ; School of Medicine and Pharmacology, University of Western Australia, Perth, WA, Australia., Harb HL; Ministry of Public Health, Beirut, Lebanon., Havmoeller R; Karolinska Institutet, Stockholm, Sweden., Hay SI; University of Oxford, Oxford, UK., Pi IB; National Institute of Public Health, Cuernavaca, Mexico., Hoek HW; Parnassia Psychiatric Institute, The Hague, Netherlands., Hosgood HD; Albert Einstein College of Medicine, Bronx, NY, USA., Hoy DG; School of Population Health, QLD, Australia; Public Health Division, Secretariat of the Pacific Community, Noumea, New Caledonia., Husseini A; Birzeit University, Birzeit, Ramallah, Palestine., Idrisov BT; Brandeis University, Waltham, MA, USA., Innos K; National Institute for Health Development, Tallinn, Estonia., Inoue M; Graduate School of Medicine, Tokyo, Japan., Jacobsen KH; George Mason University, Fairfax, VA, USA., Jahangir E; Ochsner Medical Centre, New Orleans, LA, USA., Jee SH; Graduate School of Public Health, Yonsei University, Seoul, South Korea., Jensen PN; University of Washington, Seattle, WA, USA., Jha V; Postgraduate Institute of Medical Education and Research, Chandigarh, India., Jiang G; Tianjin Centres for Diseases Control and Prevention, Tianjin, China., Jonas JB; Department of Ophthalmology, Medical Faculty Mannheim, University of Heidelberg, Heidelberg, Germany., Juel K; National Institute of Public Health, Copenhagen, Denmark., Kabagambe EK; Vanderbilt University, Nashville, TN, USA., Kan H; Fudan University, Shanghai, China., Karam NE; University of Balamand, Beirut, Lebanon., Karch A; Helmholtz Centre for Infection Research, Braunschweig, Germany., Karema CK; Malaria and Other Parasitic Diseases Division, Kigali, Rwanda., Kaul A; Oklahoma State University, Tulsa, OK, USA., Kawakami N; School of Public Health, Tokyo, Japan., Kazanjan K; National Centre for Disease Control and Public Health of Georgia, Tbilisi, Georgia., Kazi DS; University of California San Francisco, San Francisco, CA, USA., Kemp AH; University of São Paulo, São Paulo, Brazil., Kengne AP; South African Medical Research Council, Cape Town, South Africa., Kereselidze M; National Centre for Disease Control and Public Health of Georgia, Tbilisi, Georgia., Khader YS; Jordan University of Science and Technology, Al-Ramtha, Jordan., Khalifa SE; Supreme Council of Health, Doha, Qatar., Khan EA; Health Services Academy, Islamabad, Pakistan., Khang YH; Institute of Health Policy and Management, Seoul National University College of Medicine, Seoul, South Korea., Knibbs L; University of Queensland, Brisbane, QLD, Australia., Kokubo Y; Department of Preventive Cardiology, Department of Preventive Medicine and Epidemiologic Informatics, National Cerebral and Cardiovascular Centre, Suita, Japan., Kosen S; Centre for Community Empowerment, Health Policy and Humanities, National Institute of Health Research and Development, Jakarta, Indonesia., Defo BK; University of Montreal, Montreal, QC, Canada., Kulkarni C; Rajrajeshwari Medical College and Hospital, Bangalore, India., Kulkarni VS; Arkansas State University, Jonesboro, AR, USA., Kumar GA; Public Health Foundation of India, New Delhi, India., Kumar K; International Institute for Population Sciences, Mumbai, India., Kumar RB; Indian Institute of Public Health, Public Health Foundation of India, Gurgaon, India., Kwan G; Boston Medical Centre, Boston, MA, USA., Lai T; Fourth View Consulting, Tallinn, Estonia., Lalloo R; Australian Research Centre for Population Oral Health (ARCPOH), School of Dentistry, University of Adelaide, Adelaide, SA, Australia., Lam H; Institute of Health Policy and Development Studies, National Institutes of Health, Manila, Philippines., Lansingh VC; International Agency for the Prevention of Blindness and Vision 2020, Weston, FL, USA., Larsson A; Uppsala University, Uppsala, Sweden., Lee JT; Korea University, Seoul, South Korea., Leigh J; University of Sydney, NSW, Australia., Leinsalu M; National Institute for Health Development, Tallinn, Estonia., Leung R; University at Albany, Rensselaer, NY, USA., Li X; National Centre for Birth Defects Monitoring of China, Chengdu, China., Li Y; National Centre for Chronic and Non-Communicable Disease Control and Prevention, Beijing, China., Li Y; Genentech, South San Francisco, CA, USA., Liang J; National Office for Maternal and Child Health Surveillance, West China Second University Hospital, Sichuan University, Chengdu, China., Liang X; Chinese Centre for Disease Control and Prevention, Beijing, China., Lim SS; Institute for Health Metrics and Evaluation, Seattle, WA, USA., Lin HH; College of Public Health, Taipei, Taiwan., Lipshultz SE; Wayne State University, Miami, FL, USA., Liu S; National Centre for Chronic and Non-Communicable Disease Control and Prevention, Beijing, China., Liu Y; University of the East Ramon Magsaysay Memorial Medical Centre, Quezon City, Philippines., Lloyd BK; Monash University, Melbourne, VIC, Australia., London SJ; National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA., Lotufo PA; University of São Paulo, São Paulo, Brazil., Ma J; National Centre for Chronic and Non-Communicable Disease Control and Prevention, Beijing, China., Ma S; Ministry of Health Singapore, Singapore, Singapore., Machado VM; Northern Region Health Administration, Porto, Portugal., Mainoo NK; Xpharmconsult, Kumasi, Ghana., Majdan M; Department of Public Health, Faculty of Health Sciences and Social Work, Trnava University, Trnava, Slovakia., Mapoma CC; University of Zambia, Lusaka, Zambia., Marcenes W; Queen Mary University of London, London, UK., Marzan MB; University of the East Ramon Magsaysay Memorial Medical Centre, Quezon City, Philippines., Mason-Jones AJ; University of York, York, UK., Mehndiratta MM; Janakpuri Super Specialty Hospital, New Delhi, India., Mejia-Rodriguez F; National Institute of Public Health, Cuernavaca, Mexico., Memish ZA; Saudi Ministry of Health, Riyadh, Saudi Arabia., Mendoza W; UN Population Fund, Lima, Peru., Miller TR; Pacific Institute for Research and Evaluation, Calverton, MD, USA., Mills EJ; University of Ottawa, Ottawa, ON, Canada., Mokdad AH; Institute for Health Metrics and Evaluation, Seattle, WA, USA., Mola GL; University of Papua New Guinea, Port Moresby, Papua New Guinea., Monasta L; Institute for Maternal and Child Health Istituto di Ricovero e Cura a Carattere Scientifico Burlo Garofolo, Trieste, Italy., de la Cruz Monis J; Bureau of International Health Cooperation, Manila City, Philippines., Hernandez JC; National Institute of Public Health, Cuernavaca, Mexico., Moore AR; University of North Texas, Denton, TX, USA., Moradi-Lakeh M; Institute for Health Metrics and Evaluation, Seattle, WA, USA; Iran University of Medical Sciences, Department of Community Medicine, Tehran, Iran., Mori R; National Centre for Child Health and Development, Setagaya, Tokyo, Japan., Mueller UO; Philipps-University Marburg, Marburg, Germany., Mukaigawara M; Tokyo Medical and Dental University, Tokyo, Japan., Naheed A; International Centre for Diarrhoeal Diseases Research, Dhaka, Bangladesh., Naidoo KS; University of KwaZulu-Natal, Durban, South Africa., Nand D; Ministry of Health Fiji, Suva, Fiji., Nangia V; Suraj Eye Institute, Nagpur, India., Nash D; School of Public Health, State University of New York, New York, NY, USA., Nejjari C; Faculty of Medicine, Fez, Morocco., Nelson RG; National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix, AZ, USA., Neupane SP; Norwegian Centre for Addiction Research (SERAF), University of Oslo, Oslo, Norway., Newton CR; Kenya Medical Research Institute Wellcome Trust Programme, Kilifi, Kenya., Ng M; Institute for Health Metrics and Evaluation, Seattle, WA, USA., Nieuwenhuijsen MJ; Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain., Nisar MI; Aga Khan University, Karachi, Pakistan., Nolte S; Charité Universitätsmedizin Berlin, Berlin, Germany., Norheim OF; University of Bergen, Bergen, Norway., Nyakarahuka L; Makerere University, Kampala, Uganda., Oh IH; Kyung Hee Unversity, Seoul, South Korea., Ohkubo T; Teikyo University School of Medicine, Tokyo, Japan., Olusanya BO; Centre for Healthy Start Initiative, Lagos, Nigeria., Omer SB; Emory University, Atlanta, GA, USA., Opio JN; Lira District Local Government, Lira Municipal Council, Lira, Uganda., Orisakwe OE; Toxicology Unit, Faculty of Pharmacy, University of Port Harcourt, Port Harcourt, Nigeria., Pandian JD; Christian Medical College Ludhiana, Ludhiana, India., Papachristou C; Charité Universitätsmedizin Berlin, Berlin, Germany., Park JH; Sungkyunkwan University School of Medicine, Suwon, South Korea., Caicedo AJ; Universidad de Cartagena, Cartagena, Colombia., Patten SB; University of Calgary, Calgary, AB, Canada., Paul VK; All India Institute of Medical Sciences (AIIMS), New Delhi, India., Pavlin BI; WHO, Waigani, Papua New Guinea., Pearce N; London School of Hygiene & Tropical Medicine, London, UK., Pereira DM; 3B's Research Group in Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, and ICVS/3B's PT Government Associate Laboratory, Braga Portugal., Pesudovs K; Flinders University, Adelaide, SA, Australia., Petzold M; Centre for Applied Biostatistics, Sahlgrenska Academy, University of Gothenburg, Sweden., Poenaru D; McMaster University, Hamilton, ON, Canada., Polanczyk GV; University of São Paulo, São Paulo, Brazil., Polinder S; Erasmus Medical Center, Department of Public Health, Rotterdam, Netherlands., Pope D; University of Liverpool, Liverpool, UK., Pourmalek F; University of British Columbia, Vancouver, BC, Canada., Qato D; College of Pharmacy, Chicago, IL, USA., Quistberg DA; University of Washington, Seattle, WA, USA., Rafay A; Contech International, Lahore, Pakistan., Rahimi K; University of Oxford, Oxford, UK., Rahimi-Movaghar V; Sina Trauma and Surgery Research Centre, Tehran University of Medical Sciences, Tehran, Iran., ur Rahman S; Hamad Medical Corporation, Doha, Qatar., Raju M; University of Missouri, Columbia, MO, USA., Rana SM; Department of Public Health, University of the Punjab, Lahore, Pakistan., Refaat A; Walden University, Minneapolis, MN, USA., Ronfani L; Institute for Maternal and Child Health Istituto di Ricovero e Cura a Carattere Scientifico Burlo Garofolo, Trieste, Italy., Roy N; Bhaba Atomic Research Center Hospital, Mumbai, India., Pimienta TG; National Institute of Public Health, Cuernavaca, Mexico., Sahraian MA; MS Research Centre, Tehran University of Medical Sciences, Tehran, Iran., Salomon JA; Harvard University, Boston, MA, USA., Sampson U; Vanderbilt University, Nashville, TN, USA., Santos IS; University of São Paulo, São Paulo, Brazil., Sawhney M; Marshall University, Huntington, WV, USA., Sayinzoga F; Ministry of Health, Kigali, Rwanda., Schneider IJ; Federal University of Santa Catarina, Florianópolis, Brazil., Schumacher A; Institute for Health Metrics and Evaluation, Seattle, WA, USA., Schwebel DC; University of Alabama at Birmingham, Birmingham, AL, USA., Seedat S; Stellenbosch University, Cape Town, South Africa., Sepanlou SG; Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran., Servan-Mori EE; National Institute of Public Health, Cuernavaca, Mexico., Shakh-Nazarova M; National Centre for Disease Control and Public Health of Georgia, Tbilisi, Georgia., Sheikhbahaei S; Endocrinology and Metabolism Research Centre, Tehran University of Medical Sciences, Tehran, Iran., Shibuya K; University of Tokyo, Tokyo, Japan., Shin HH; Health Canada, Ottawa, ON, Canada., Shiue I; Heriot-Watt University, Edinburgh, UK., Sigfusdottir ID; Reykjavik University, Reykjavik, Iceland., Silberberg DH; University of Pennsylvania, Philadelphia, PA, USA., Silva AP; Instituto Nacional de Epidemiología Dr Juan H Jara, Mar del Plata, Buenos Aires, Argentina., Singh JA; University of Alabama at Birmingham, Birmingham, AL, USA., Skirbekk V; Norwegian Institute of Public Health, Oslo, Norway., Sliwa K; Hatter Institute for Cardiovascular Research in Africa, Faculty of Health Sciences, Cape Town, South Africa., Soshnikov SS; Federal Research Institute for Health Organisation and Informatics of Ministry of Health of the Russian Federation, Moscow, Russia., Sposato LA; Department of Clinical Neurological Sciences, Western University, London, ON, Canada., Sreeramareddy CT; University Tunku Abdul Rahman, Kajang, Malaysia., Stroumpoulis K; Hellenic Centre for Disease Control and Prevention (KEELPNO) Greece, Athens, Greece., Sturua L; National Centre for Disease Control and Public Health of Georgia, Tbilisi, Georgia., Sykes BL; Department of Criminology, Law and Society (and Sociology), University of California Irvine, Irvine, CA, USA., Tabb KM; University of Illinois, Chicago, IL, USA., Talongwa RT; Ministry of Public Health, Yaounde, Cameroon., Tan F; National Institute of Occupational Health and Poison Control, Beijing, China., Teixeira CM; Departamento de Saúde Pública, ARS Norte IP, Porto, Portugal., Tenkorang EY; Memorial University, St John's, NL, Canada., Terkawi AS; Department of Anesthesiology, University of Virginia, Charlottesville, VA, USA; Department of Anesthesiology, King Fahad Medical City, Riyadh, Saudi Arabia., Thorne-Lyman AL; The Earth Institute, Columbia University, New York, NY, USA., Tirschwell DL; Department of Neurology, Seattle, WA, USA., Towbin JA; Cincinnati Children's Hospital Medical Centre, Cincinnati, OH, USA., Tran BX; Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA., Tsilimbaris M; Department of Medicine, University of Crete, Heraklion, Greece., Uchendu US; Department of Veterans Affairs, Washington, DC, USA., Ukwaja KN; Department of Internal Medicine, Federal Teaching Hospital Abakaliki, Abakaliki, Nigeria., Undurraga EA; Brandeis University, Waltham, MA, USA., Uzun SB; Ministry of Health, Ankara, Turkey., Vallely AJ; The Kirby Institute, Sydney, NSW, Australia., van Gool CH; National Institute for Public Health and the Environment, Bilthoven, Netherlands., Vasankari TJ; UKK Institute for Health Promotion Research, Tampere, Finland., Vavilala MS; University of Washington, Seattle, WA, USA., Venketasubramanian N; Neuroscience Centre, Raffles Hospital, Singapore., Villalpando S; National Institute of Public Health, Cuernavaca, Mexico., Violante FS; University of Bologna, Bologna, Italy., Vlassov VV; Higher School of Economics, Moscow, Russia., Vos T; Institute for Health Metrics and Evaluation, Seattle, WA, USA., Waller S; Uniformed Services University of Health Sciences, Bethesda, MD, USA., Wang H; Institute for Health Metrics and Evaluation, Seattle, WA, USA., Wang L; National Centre for Chronic and Non-Communicable Disease Control and Prevention, Beijing, China., Wang X; Shandong University Affiliated Jinan Central Hospital, Jinan, China., Wang Y; National Office for Maternal and Child Health Surveillance, West China Second University Hospital, Sichuan University, Chengdu, China., Weichenthal S; Health Canada, Ottawa, ON, Canada., Weiderpass E; Department of Medical Epidemiology and Biostatistics, Stockholm, Sweden., Weintraub RG; University of Melbourne, Melbourne, VIC, Australia; Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, VIC, Australia., Westerman R; Philipps-University Marburg, Marburg, Germany., Wilkinson JD; University of Miami, Miami, FL, USA., Woldeyohannes SM; Institute of Public Health, University of Gondar, Gondar, Ethiopia., Wong JQ; Ateneo School of Medicine and Public Health, City of Pasig, Manila, Philippines., Wordofa MA; Jimma University, Jimma, Ethiopia., Xu G; Nanjing University School of Medicine, Jinling Hospital, Nanjing, China., Yang YC; University of North Carolina at Chapel Hill, Chapel Hill, NC, USA., Yano Y; Division of Cardiovascular Medicine, Jichi Medical University School of Medicine, Shimotsuke, Japan., Yentur GK; General Directorate of Health Research, Ankara, Turkey., Yip P; University of Hong Kong, Hong Kong Special Administrative Region, China., Yonemoto N; National Centre of Neurology and Psychiatry, Kodaira, Japan., Yoon SJ; Korea University, Seoul, South Korea., Younis MZ; Jackson State University, Jackson, MS, USA., Yu C; Department of Epidemiology and Biostatistics, Global Health Institute, School of Public Health, Wuhan University, Wuhan, China., Jin KY; TCM Medical Tk, Nusajaya, Johor Bahru, Malaysia., El Sayed Zaki M; Mansoura Faculty of Medicine, Mansoura, Egypt., Zhao Y; Chongqing Medical University, Chongqing, China., Zheng Y; Zhongshan Ophthalmic Centre, Sun Yat-sen University, Guangzhou, China., Zhou M; National Centre for Chronic and Non-Communicable Disease Control and Prevention, Beijing, China., Zhu J; National Office for Maternal and Child Health Surveillance, West China Second University Hospital, Sichuan University, Chengdu, China., Zou XN; Cancer Institute and Hospital, Chinese Academy of Medical Sciences, Beijing, China., Lopez AD; University of Melbourne, Melbourne, VIC, Australia., Naghavi M; Institute for Health Metrics and Evaluation, Seattle, WA, USA., Murray CJ; Institute for Health Metrics and Evaluation, Seattle, WA, USA., Lozano R; Institute for Health Metrics and Evaluation, Seattle, WA, USA; National Institute of Public Health, Cuernavaca, Mexico.
Jazyk:	angličtina
Zdroj:	Lancet (London, England) [Lancet] 2014 Sep 13; Vol. 384 (9947), pp. 980-1004. Date of Electronic Publication: 2014 May 02.
DOI:	10.1016/S0140-6736(14)60696-6
Abstrakt:	Background: The fifth Millennium Development Goal (MDG 5) established the goal of a 75% reduction in the maternal mortality ratio (MMR; number of maternal deaths per 100,000 livebirths) between 1990 and 2015. We aimed to measure levels and track trends in maternal mortality, the key causes contributing to maternal death, and timing of maternal death with respect to delivery. Methods: We used robust statistical methods including the Cause of Death Ensemble model (CODEm) to analyse a database of data for 7065 site-years and estimate the number of maternal deaths from all causes in 188 countries between 1990 and 2013. We estimated the number of pregnancy-related deaths caused by HIV on the basis of a systematic review of the relative risk of dying during pregnancy for HIV-positive women compared with HIV-negative women. We also estimated the fraction of these deaths aggravated by pregnancy on the basis of a systematic review. To estimate the numbers of maternal deaths due to nine different causes, we identified 61 sources from a systematic review and 943 site-years of vital registration data. We also did a systematic review of reports about the timing of maternal death, identifying 142 sources to use in our analysis. We developed estimates for each country for 1990-2013 using Bayesian meta-regression. We estimated 95% uncertainty intervals (UIs) for all values. Findings: 292,982 (95% UI 261,017-327,792) maternal deaths occurred in 2013, compared with 376,034 (343,483-407,574) in 1990. The global annual rate of change in the MMR was -0·3% (-1·1 to 0·6) from 1990 to 2003, and -2·7% (-3·9 to -1·5) from 2003 to 2013, with evidence of continued acceleration. MMRs reduced consistently in south, east, and southeast Asia between 1990 and 2013, but maternal deaths increased in much of sub-Saharan Africa during the 1990s. 2070 (1290-2866) maternal deaths were related to HIV in 2013, 0·4% (0·2-0·6) of the global total. MMR was highest in the oldest age groups in both 1990 and 2013. In 2013, most deaths occurred intrapartum or postpartum. Causes varied by region and between 1990 and 2013. We recorded substantial variation in the MMR by country in 2013, from 956·8 (685·1-1262·8) in South Sudan to 2·4 (1·6-3·6) in Iceland. Interpretation: Global rates of change suggest that only 16 countries will achieve the MDG 5 target by 2015. Accelerated reductions since the Millennium Declaration in 2000 coincide with increased development assistance for maternal, newborn, and child health. Setting of targets and associated interventions for after 2015 will need careful consideration of regions that are making slow progress, such as west and central Africa. Funding: Bill & Melinda Gates Foundation. (Copyright © 2014 Elsevier Ltd. All rights reserved.)
Databáze:	MEDLINE
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