Læknablaðið - 01.03.2023, Blaðsíða 24

140 L ÆKNABL AÐIÐ 2023/109
E N G L I S H S U M M A R Y
Maternal death in Iceland 1976-2015
INTRODUCTION: Maternal deaths are rare and an indirect measure of the societal framework surrounding
pregnancy and childbirth. We surveyed and classified maternal mortality in Iceland using international
guidelines, calculating changes over a 40-year period.
MATERIAL AND METHODS: Information from Statistics Iceland on women aged 15-49 years who died in 1985-
2015 were cross-checked against birth registration and hospital admission data to identify women who died in
pregnancy or ≤42 and within 43-365 days from birth or termination of a pregnancy. Data for 1976-1984 were
searched manually. Case records and autopsy reports were scrutinized. Deaths were classified as direct,
indirect or coincidental and as early or late.
RESULTS: Among 1600 women 48 died in pregnancy or within a year after pregnancy. Births totaled 172369 and
overall maternal mortality was 27.8/100.000 births. Maternal mortality by World Health Organization criteria
(direct/indirect ≤42 days) occurred in 14 instances giving a maternal mortality ratio (MMR) of 8.1/100.000. Rates
lowered between the first and last 10-year periods, particularly initially followed by a lesser downward trend.
Direct deaths were 6, indirect 20, coincidental 22 (accidents, diseases). Causes of direct deaths were severe
preeclampsia, pulmonary embolism and choriocarcinoma. Underlying causes of indirect deaths included cancer,
diabetes, brain/heart conditions and suicide. No deaths occurred from ectopic pregnancy, hemorrhage or
anesthesia.
CONCLUSIONS: Maternal mortality in Iceland is among the lowest reported. Women died because of the
pregnancy, from worsening of underlying conditions or coincidentally. Risk groups require better support.
Continued attention to adverse health connected to maternity is essential.
doi 10.17992/lbl.2023.03.734
dauðsföllum í þungun og innan 42ja fyrstu daganna frá lokum
hennar, en heildartölur upp að einu ári breyttust minna síðustu
þrjá áratugina. Þetta gerðist enda þótt konum á barneignaaldri
fjölgaði talvert á sama tíma, barneignum á hverja konu fækkaði
og árlegur fæðingafjöldi breyttist lítið. Þó ekki sé unnt að leggja
of mikið upp úr tölfræðilegri marktækni vegna smæðar efni-
viðarins og víðra frávika, tala þessar heildartölur sínu máli um
Heimildir
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Greinin barst til blaðsins 21. október 2022,
samþykkt til birtingar 20. febrúar 2023.
markverðan árangur sem endurspeglar gæði heilbrigðisþjónustu
og meðgönguverndar á Íslandi. Áskorun samtímans er að halda
mæðradauða á Íslandi með því allra lægsta sem gerist. Þá þarf
áfram að viðhalda sem bestu öryggi í meðgönguvernd og vinna
í því hvernig þungun og eftirmál þungunar eru skráð og með-
höndluð. Til þess þarf skráningar- og úrvinnslukerfi sem getur
verið til fyrirmyndar.
Hera Birgisdóttir1
Thor Aspelund2,3
Reynir Tómas Geirsson4,5
1The Healthcare Institution of North Iceland
Sauðárkróki, 2Center for Public Health
University of Iceland, 3The Icelandic Heart
Association, 4Women´s Clinic, Landspitali
National University Hospital, 5Faculty of
Medicine, University of Iceland.
Correspondence: Reynir Tómas Geirsson,
reynirg@landspitali.is
Key words: maternal death, maternal mortality,
pregnancy, pregnancy complications, mortality,
morbidity.