Maternal mortality rate and its causes in the South of Iran

The maternal mortality rate (MMR) often reflects the development status of one country. This study calculates the incidence rate of maternal mortality and examines the related risk factors in Fars Province, located in South of Iran. Using the surveillance system of Shiraz University of Medical Sciences, we reviewed all childbirth records from 2002 to 2012 in which maternal mortality occurred. Of 747,077 pregnancies, the average MMR was 21.28 per 100,000 live births per year, with a decreasing but non-significant trend. In rural areas, the MMR was more than twice as high as in urban areas. The most common cause of maternal death was maternal hemorrhage (27%), followed by pre-eclampsia (15.7%) and infections (13.2%). Although the MMR gradually decreased, this decrease was not significant. Based on the higher MMR in rural areas, maternal and specialty post-partum care in rural areas should be improved and promoted. Hemorrhage is still the main cause of maternal mortality in Fars Province. Since high percentage of these cases are preventable, increased healthcare during pregnancy, reduction of cesarean sections, more well-equipped facilities, and hemorrhage-control teams in maternity hospitals would likely have a significantly positive impact on MMR.