[Study on maternal deaths in Beijing, from 1996 to 2010].

OBJECTIVE: To provide evidence for further reducing the maternal mortality rate (MMR) through analyzing the causes of death and influencing factors on the issue. METHODS: Every maternal death from 1996 to 2010 was audited by experts and relevant information was collected and analyzed retrospectively. RESULTS: (1) The overall MMR among Beijing residents was 20.2 per 100 000 live births in 1996 - 2000 while decreased to 14.2 per 100 000 live births from 2006 to 2010. At the same time the MMR of migrating people decreased from 47.7 to 15.2 per 100 000 live births. (2) The proportion of women having received middle school education and above increased from 59.8% to 78.8% and the non-prenatal care maternal ratio decreased from 39.1% to 12.7%. (3) Among the 349 deaths in the period of 1996 - 2010 209 (59.9%) were caused by direct obstetric reasons. Proportion of obstetric hemorrhage declined from 14.4% to 9.2% and the amniotic fluid embolism declined from 20.7% to 15.0%. Prolific non-prenatal care and private clinics/home deliveries were important factors on direct obstetric reasons. 71.4% maternal mortality of indirect causes appeared abnormal during pregnancy. (4) The WHO twelve-grade classification standard on maternal deaths was adopted. Our data showed that the main reasons causing maternal deaths of Beijing residents were related to the skills of medical staffs (62.4%) and healthcare management (19.7%). The main reasons of maternal deaths among migrating people would include: poor knowledge (41.4%) inappropriate attitude (32.3%) and resources of the families (24.0%). CONCLUSION: The MMR in Beijing continuously declined from 1996 to 2010. However in order to keep up with the changing causes related to maternal deaths as well as to the increasing service requirements it is necessary to develop a new model on service and management of the issue.