Publication:

Determinants of in-hospital maternal mortality in the Atlantique department of Benin Republic from 2019 to 2022

Background The decline of the maternal mortality ratio (MMR) in Benin is too slow to achieve the third sustainable development goal by 2030. The aim of the study was to identify the determinants of in-hospital maternal mortality in the Atlantique department of Benin Republic from 2019 to 2022.

Methods The study was conducted in two district hospitals in the Atlantique department. It was a retrospective case-control study from 2019 to 2022. Cases included all in-hospital maternal deaths, while controls were survivors of obstetric complications. A multivariate analysis was performed with a significance threshold of 0.05.

Results We identified 92 cases of maternal deaths and 276 controls. The maternal mortality ratio was 386 maternal deaths per 100,000 live births. The mean age of the cases was 28.67±6.54 years, while that of the controls was 26.46±6.60 years. Prenatal care was poorly followed (88.04% versus 79.71%), and most patients were referred (77.20% versus 76.10%). Several factors were associated with maternal death, including: presence of medical history (p=0.030), presence of pregnancy-related pathology (p=0.049), questionable treatment (p<0.001), inadequate monitoring (p<0.001), occurrence of maternal complications (p<0.001), indication for blood transfusion (p<0.001), in-hospital delay in providing emergency obstetric care (p<0.001).

Conclusions Identifying the main determinants of in-hospital maternal death will help to target appropriate high-impact interventions and optimize their implementation in order to accelerate the reduction of maternal mortality.