{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T15:12:29Z","timestamp":1790694749652,"version":"4.1.0"},"reference-count":11,"publisher":"Wiley","issue":"s4","license":[{"start":{"date-parts":[[2014,9,18]],"date-time":"2014-09-18T00:00:00Z","timestamp":1410998400000},"content-version":"vor","delay-in-days":17,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2014,9]]},"abstract":"<jats:p>Understanding the causes of and factors contributing to maternal deaths is critically important for development of interventions that reduce the global burden of maternal mortality and morbidity. The International Classification of Diseases\u2014Maternal Mortality (<jats:styled-content style=\"fixed-case\">ICD<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">MM<\/jats:styled-content>) classification of cause of death during pregnancy, childbirth and the puerperium was applied to data obtained from maternal death reviews (<jats:styled-content style=\"fixed-case\">MDR<\/jats:styled-content>) for 4558 maternal deaths from five countries in sub\u2010<jats:styled-content style=\"fixed-case\">S<\/jats:styled-content>aharan <jats:styled-content style=\"fixed-case\">A<\/jats:styled-content>frica. None of the data sets identified type of maternal death. Information obtained via <jats:styled-content style=\"fixed-case\">MDR<\/jats:styled-content> is generally sufficient to agree on classification of cause of death to the levels of type and group. The terms \u2018underlying cause of death\u2019 and \u2018contributing conditions\u2019 were used differently in different settings and a specific underlying cause of death was frequently not recorded. Application of <jats:styled-content style=\"fixed-case\">ICD<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">MM<\/jats:styled-content> resulted in the reclassification of 3.1% (9\/285) of cases to the group \u2018unanticipated complications of management\u2019, previously recorded as obstetric haemorrhage or unknown. An increased number of cases were assigned to the groups pregnancy\u2010related infection (5.6\u201310.2%) and pregnancies with abortive outcome (3.4\u20134.9%) when a clear distinction was made between women who died \u2018with\u2019 <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">AIDS<\/jats:styled-content> of obstetric causes (direct maternal death) and <jats:styled-content style=\"fixed-case\">AIDS<\/jats:styled-content>\u2010related indirect maternal deaths (group \u2018non\u2010obstetric complications\u2019). Similarly, anaemia and obstructed labour were more frequently identified as contributing factors than underlying cause of death. It would be helpful if <jats:styled-content style=\"fixed-case\">MDR<\/jats:styled-content> forms could have explicitly stated variables called: type, group and underlying cause of death as well as a dedicated section to the most frequently occurring contributing conditions recognised in that setting.<\/jats:p>","DOI":"10.1111\/1471-0528.12987","type":"journal-article","created":{"date-parts":[[2014,9,18]],"date-time":"2014-09-18T11:11:00Z","timestamp":1411038660000},"page":"32-40","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":31,"title":["Using the new <scp>ICD<\/scp>\u2010<scp>MM<\/scp> classification system for attribution of cause of maternal death\u2014a pilot study"],"prefix":"10.1111","volume":"121","author":[{"given":"CA","family":"Ameh","sequence":"first","affiliation":[{"name":"Centre for Maternal and Newborn Health Liverpool School of Tropical Medicine Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Adegoke","sequence":"additional","affiliation":[{"name":"Centre for Maternal and Newborn Health Liverpool School of Tropical Medicine Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"RC","family":"Pattinson","sequence":"additional","affiliation":[{"name":"SA MRC Maternal and Infant Health Care Strategies Unit, Department of Obstetrics and Gynaecology University of Pretoria Pretoria South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N","family":"van den Broek","sequence":"additional","affiliation":[{"name":"Centre for Maternal and Newborn Health Liverpool School of Tropical Medicine Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2014,9,18]]},"reference":[{"key":"e_1_2_5_2_1","volume-title":"Maternal Mortality in 2005","author":"WHO, UNICEF, UNFPA, World Bank","year":"2008"},{"key":"e_1_2_5_3_1","volume-title":"Trends in Maternal Mortality: 1990 to 2010: WHO, UNICEF, UNFPA, and The World Bank Estimates","author":"WHO, UNICEF, UNFPA, World Bank","year":"2012"},{"key":"e_1_2_5_4_1","volume-title":"Trends in Maternal Mortality 1990 to 2013: Estimates by the WHO, UNICEF, UNFPA, The World Bank and the United Nations Population Division","author":"WHO, UNICEF, UNFPA, The World Bank and the United Nations Population Division","year":"2014"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)60518-1"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(11)61337-8"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/0277-9536(94)90226-7"},{"key":"e_1_2_5_8_1","volume-title":"ICD\u201010 International Statistical Classification of Diseases and Related Health Problems","author":"World Health Organization","year":"2004"},{"key":"e_1_2_5_9_1","volume-title":"Beyond the Numbers: Reviewing Maternal Deaths and Complications to Make Pregnancy Safer","author":"WHO, Department of Reproductive Health and Research","year":"2004"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(06)68397-9"},{"key":"e_1_2_5_11_1","volume-title":"The WHO Application of ICD\u201010 to Deaths During Pregnancy, Childbirth and the Puerperium: ICD\u2010MM","author":"World Health Organization","year":"2012"},{"key":"e_1_2_5_12_1","first-page":"15","volume-title":"Saving mothers, 2005\u20132007: Fourth Report on Confidential Enquiries into Maternal Deaths in South Africa","author":"Pattinson R","year":"2008"}],"container-title":["BJOG: An International Journal of Obstetrics &amp; Gynaecology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2F1471-0528.12987","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1471-0528.12987","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,13]],"date-time":"2023-09-13T05:01:47Z","timestamp":1694581307000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/1471-0528.12987"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,9]]},"references-count":11,"journal-issue":{"issue":"s4","published-print":{"date-parts":[[2014,9]]}},"alternative-id":["10.1111\/1471-0528.12987"],"URL":"https:\/\/doi.org\/10.1111\/1471-0528.12987","archive":["Portico"],"relation":{},"ISSN":["1470-0328","1471-0528"],"issn-type":[{"value":"1470-0328","type":"print"},{"value":"1471-0528","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,9]]},"assertion":[{"value":"2014-06-06","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2014-09-18","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}