Impact of emerging virus pandemics on cause-specific maternal mortality time series: a population-based natural experiment using national vital statistics, Argentina 1980-2017
Abstract: Abstract Background Emerging pandemic viruses may have multiple deleterious effects on maternal health. This study examines the effects of a pandemic influenza virus on cause-specific maternal mortality time series, using Argentinian vital statistics. Methods We conducted a population-b...
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| Autores principales: | , , , , , , |
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| Formato: | Artículo |
| Lenguaje: | Inglés |
| Publicado: |
Elsevier
2022
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| Materias: | |
| Acceso en línea: | https://repositorio.uca.edu.ar/handle/123456789/14316 |
| Aporte de: |
| Sumario: | Abstract: Abstract
Background Emerging pandemic viruses may have multiple deleterious effects on maternal health. This study
examines the effects of a pandemic influenza virus on cause-specific maternal mortality time series, using Argentinian vital statistics.
Methods We conducted a population-based natural experiment from national vital records of maternal deaths
between 1980 and 2017. Joinpoint regression models were used to model time series of the maternal mortality ratio
(MMR). The sensitivity of the registry to detect the effects of the pandemic H1N1 2009 influenza virus on cause-specific MMR was analysed using a panel of parallel interrupted time series (ITS).
Findings Over this 38-year study, the MMR decreased by 58¢6% (69¢5 to 28¢8 deaths/100,000 live births), transitioning from direct obstetric causes (67¢0 to 21¢1/100,000 live births; 68¢4% decrease) to indirect causes (2¢6 to 7¢7/
100,000 live births; 196¢2% increase). The regression analysis showed an average reduction of -2¢2%/year (95% CI:
-2¢9 to -1¢4) with 2 join points in the total trend (1998 and 2009). Parallel ITS analyses revealed the pandemic H1N1
virus had an increasing effect on mortality from the respiratory system- and sepsis-related complications (level
change 4¢7 and 1¢6/100,000 live births respectively), reversing after the outbreak. No effect was found on MMR
from hypertensive disorders, haemorrhage, abortive outcomes, other direct obstetric causes, and indirect non-respiratory comorbidities.
Interpretation The Argentinian maternal death registry appears sensitive to detect different effects of emerging
infectious epidemics on maternal health. In a population-based natural experiment, pandemic H1N1 virus impacted
maternal mortality almost exclusively from the respiratory system- and sepsis-related complications. |
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