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BJOG. 2017 Jun;124(7):1115-1121. doi: 10.1111/1471-0528.14484. Epub 2016 Dec 28.

Decreasing mortality during pregnancy and for a year after while mortality after termination of pregnancy remains high: a population-based register study of pregnancy-associated deaths in Finland 2001-2012.

Author information

1
Department of Obstetrics and Gynecology, University of Helsinki, Helsinki University Hospital, Helsinki, Finland.
2
University of Helsinki, Hyvinkää Hospital, Hyvinkää, Finland.
3
THL, National Institute for Health and Welfare, Helsinki, Finland.
4
Department of Neurobiology, Care Sciences and Society, Division of Family Medicine, Karolinska Institute, Stockholm, Sweden.

Abstract

OBJECTIVE:

To investigate mortality in the non-pregnant fertile female population, and mortality during pregnancy and up to 1 year after the end of pregnancy, in Finland from 2001 to 2012 and compare the results with those of 1987-2000.

DESIGN:

Retrospective cohort study.

SETTING:

Finland.

POPULATION:

10 427 deceased women of reproductive age (15-49).

METHODS:

Pregnancy outcomes were categorised into: ongoing pregnancy or birth, miscarriage or ectopic pregnancy and termination of pregnancy. Mortality was calculated per 100 000 pregnancies. The mortality rate of the non-pregnant female population of fertile age was calculated per 100 000 person-years, and the results were compared with those of 1987-2000.

MAIN OUTCOME MEASURES:

Pregnancy-associated mortality during pregnancy and up to 1 year after the end of pregnancy. Mortality of non-pregnant, fertile-age, female population.

RESULTS:

The age-adjusted mortality rate during pregnancy and within 1 year after the end of pregnancy was 28.4/100 000 pregnancies, and it had significantly decreased compared with the period 1987-2000 [risk ratio (RR) 0.75 (95% CI, 0.65-0.88)]. Mortality in non-pregnant fertile-age females was 48.1/100 000 person-years. Mortality for diseases and medical conditions during and after pregnancy decreased by 26% [RR 0.74 (95% CI, 0.59-0.92)] and for external causes by 23% [RR 0.77 (95% CI, 0.62-0.95)]. The mortality rate for suicides was 3.3/100 000 in ongoing pregnancies and pregnancies ending in birth while it was 21.8/100 000 after termination of pregnancy and 10.2/100 000 among non-pregnant women.

CONCLUSIONS:

In comparison with earlier decades, pregnancy-associated mortality has decreased in Finland.

TWEETABLE ABSTRACT:

Mortality decreases among pregnant women and within 1 year after pregnancy in Finland.

KEYWORDS:

Delivery; ectopic pregnancy; homicide; mortality; pregnancy; suicide; termination of pregnancy; women

PMID:
28029218
DOI:
10.1111/1471-0528.14484
[Indexed for MEDLINE]
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