{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T04:48:27Z","timestamp":1782881307276,"version":"3.54.5"},"reference-count":36,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,12,7]],"date-time":"2024-12-07T00:00:00Z","timestamp":1733529600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001717","name":"Universiteit Leiden","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001717","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp; Obste"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>The aim of this study was to identify factors associated with maternal mortality in 13 public hospitals with maternity units in eastern Ethiopia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A nested case\u2010control study embedded within the Ethiopian Obstetric Surveillance System (EthOSS) cohort. EthOSS was established in April 2021 to monitor women admitted with severe obstetric complications (e.g., obstetric hemorrhage, eclampsia, uterine rupture, sepsis, and severe anemia) during pregnancy, childbirth or within 42\u2009days of termination of pregnancy. The cases were all women who died during pregnancy, childbirth, or postpartum in these hospitals, while women who survived these complications were the controls. For each case, we randomly selected three controls. The factors associated with maternal mortality were described using adjusted odds ratios (aOR) with their corresponding 95% confidence intervals (CI). Associations were examined using binary logistic regression analysis followed by multivariable logistic regression analysis for factors with <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.25. Finally, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05 was considered as the cut\u2010off for a statistically significant association.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 280 women (70 cases and 210 controls) were included in the study. Compared to survivors, women who died were more likely to have given birth by caesarean section (aOR\u2009=\u20093.35; 95% CI 1.49\u20137.53), to have been admitted into an intensive care unit (aOR\u2009=\u20096.58; 95% CI 2.08\u201320.82), to have had postpartum hemorrhage (aOR\u2009=\u20096.39; 95% CI 2.56\u201315.94), and to have had a pre\u2010existing medical condition (aOR\u2009=\u20095.39; 95% CI 1.16\u201324.99).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Improving maternal survival requires appropriate indications for caesarean sections, safe surgical conditions, seamless communication between facilities (particularly in high\u2010risk pregnancies), adequate multidisciplinary care for women with pre\u2010existing conditions, and effective intensive care.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ijgo.16069","type":"journal-article","created":{"date-parts":[[2024,12,7]],"date-time":"2024-12-07T12:08:21Z","timestamp":1733573301000},"page":"630-638","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Factors associated with maternal mortality in eastern Ethiopia: A multicenter case\u2013control study"],"prefix":"10.1002","volume":"169","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4143-3297","authenticated-orcid":false,"given":"Mohammed","family":"Yuya","sequence":"first","affiliation":[{"name":"School of Public Health, College of Health and Medical Science Haramaya University  Harar Ethiopia"},{"name":"Department of Obstetrics and Gynaecology Leiden University Medical Center  Leiden The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2735-7523","authenticated-orcid":false,"given":"Abera Kenay","family":"Tura","sequence":"additional","affiliation":[{"name":"School of Nursing and Midwifery, College of Health and Medical Science Haramaya University  Harar Ethiopia"},{"name":"Department of Obstetrics and Gynaecology, University Medical Centre Groningen University of Groningen  Groningen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3858-190X","authenticated-orcid":false,"given":"Sagni","family":"Girma","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Leiden University Medical Center  Leiden The Netherlands"},{"name":"School of Nursing and Midwifery, College of Health and Medical Science Haramaya University  Harar Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-5202-3118","authenticated-orcid":false,"given":"Redwan","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Hiwotfana Specialized University Hospital  Harar Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1984-4575","authenticated-orcid":false,"given":"Marian","family":"Knight","sequence":"additional","affiliation":[{"name":"National Perinatal Epidemiology Unit University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9890-9145","authenticated-orcid":false,"given":"Thomas","family":"van den Akker","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Leiden University Medical Center  Leiden The Netherlands"},{"name":"Athena Institute, Vrije Universiteit Amsterdam  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,12,7]]},"reference":[{"key":"e_1_2_11_2_1","volume-title":"Trends in Maternal Mortality 2000 to 2020: Estimates by WHO, UNICEF, UNFPA, World Bank Group and UNDESA\/Population Division","author":"World Health Organization","year":"2023"},{"key":"e_1_2_11_3_1","volume-title":"Trends in Maternal Mortality 2000 to 2017: Estimates by WHO, UNICEF, UNFPA, World Bank Group and the United Nations Population Division: Executive Summary","author":"World Health Organization","year":"2019"},{"key":"e_1_2_11_4_1","volume-title":"National Maternal and Perinatal Death Surveillance and Response (MPDSR) System Annual Report of 2013 EFY","author":"Ethiopian Public Health Institute","year":"2014"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1177\/1028315307303542"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0144975"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.9745\/GHSP-D-22-00281"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(06)68397-9"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/s2214-109x(14)70227-x"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.9745\/GHSP-D-19-00366"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2019-031328"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0223540"},{"key":"e_1_2_11_13_1","volume-title":"World Health Statistics 2016: Monitoring Health for the SDGs Sustainable Development Goals","author":"WHO","year":"2016"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-017-1640-x"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.24843\/SOCA.2020.v14.i03.p15"},{"key":"e_1_2_11_16_1","volume-title":"Health Sector Strategic Plan (HSDP\u2010III) 2005\/6\u20132009\/10","author":"Federal Ministry of Health","year":"2005"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/s2214-109x(22)00518-6"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2004.02.009"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2303966"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-020-03276-1"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0153396"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.11606\/s1518-8787.2017051000389"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2018.08.586"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(18)32386-9"},{"issue":"5","key":"e_1_2_11_25_1","article-title":"Referral service barriers in Ethiopia: experiences and perceptions of actors","volume":"35","author":"Hailemichael A","year":"2021","journal-title":"Ethiop J Heal Dev"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.midw.2019.08.010"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-015-0493-4"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amsu.2022.104458"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijgo.13241"},{"key":"e_1_2_11_30_1","doi-asserted-by":"crossref","unstructured":"SoaresFM GuidaJP.Use of intensive care unit in women with severe maternal morbidity and maternal death: results from a National Multicenter Study.2020;42(3):124\u2010132. doi:10.1055\/s-0040-1708095","DOI":"10.1055\/s-0040-1708095"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2393-14-38"},{"key":"e_1_2_11_32_1","doi-asserted-by":"publisher","DOI":"10.2147\/IJWH.S327750"},{"key":"e_1_2_11_33_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2021-053357"},{"key":"e_1_2_11_34_1","doi-asserted-by":"publisher","DOI":"10.1080\/16549716.2022.2034135"},{"key":"e_1_2_11_35_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-016-1142-2"},{"key":"e_1_2_11_36_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.14933"},{"key":"e_1_2_11_37_1","unstructured":"TuraAK AkkerTV RoosmalenJV et\u00a0al.Beyond Tanzania: PartoMa team is expanding to Ethiopia. Secondary Beyond Tanzania: PartoMa team is expanding to Ethiopia;2023. Accessed 15 April 2023.https:\/\/publichealth.ku.dk\/about\u2010the\u2010department\/global\/research\/partoma\u2010project\/news\u2010from\u2010partoma\u2010project\/beyond\u2010tanzania\u2010partoma\u2010team\u2010is\u2010expanding\u2010to\u2010ethiopia\/"}],"container-title":["International Journal of Gynecology &amp; Obstetrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ijgo.16069","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,21]],"date-time":"2025-04-21T15:08:21Z","timestamp":1745248101000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1002\/ijgo.16069"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,7]]},"references-count":36,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2025,5]]}},"alternative-id":["10.1002\/ijgo.16069"],"URL":"https:\/\/doi.org\/10.1002\/ijgo.16069","archive":["Portico"],"relation":{},"ISSN":["0020-7292","1879-3479"],"issn-type":[{"value":"0020-7292","type":"print"},{"value":"1879-3479","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,12,7]]},"assertion":[{"value":"2024-04-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-11-18","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-12-07","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}