TY  - JOUR
PY  - 2014//
TI  - Global, regional, and national levels and causes of maternal mortality during 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013
JO  - Lancet
A1  - Kassebaum, Nicholas J.
A1  - Bertozzi-Villa, Amelia
A1  - Coggeshall, Megan S.
A1  - Shackelford, Katya A.
A1  - Steiner, Caitlyn
A1  - Heuton, Kyle R.
A1  - Gonzalez-Medina, Diego
A1  - Barber, Ryan
A1  - Huynh, Chantal
A1  - Dicker, Daniel
A1  - Templin, Tara
A1  - Wolock, Timothy M.
A1  - Ozgoren, Ayse Abbasoglu
A1  - Abd-Allah, Foad
A1  - Abera, Semaw Ferede
A1  - Abubakar, Ibrahim
A1  - Achoki, Tom
A1  - Adelekan, Ademola
A1  - Ademi, Zanfina
A1  - Adou, Arsène Kouablan
A1  - Adsuar, José C.
A1  - Agardh, Emilie E.
A1  - Akena, Dickens Howard
A1  - Alasfoor, Deena
A1  - Alemu, Zewdie Aderaw
A1  - Alfonso-Cristancho, Rafael
A1  - Alhabib, Samia
A1  - Ali, Raghib
A1  - Al Kahbouri, Mazin J.
A1  - Alla, François
A1  - Allen, Peter J.
A1  - Almazroa, Mohammad A.
A1  - Alsharif, Ubai
A1  - Alvarez, Elena
A1  - Alvis-Guzmán, Nelson
A1  - Amankwaa, Adansi A.
A1  - Amare, Azmeraw T.
A1  - Amini, Hassan
A1  - Ammar, Walid
A1  - Antonio, Carl A. T.
A1  - Anwari, Palwasha
A1  - Arnlöv, Johan
A1  - Arsenijevic, Valentina S. Arsic
A1  - Artaman, Ali
A1  - Asad, Majed Masoud
A1  - Asghar, Rana J.
A1  - Assadi, Reza
A1  - Atkins, Lydia S.
A1  - Badawi, Alaa
A1  - Balakrishnan, Kalpana
A1  - Basu, Arindam
A1  - Basu, Sanjay
A1  - Beardsley, Justin
A1  - Bedi, Neeraj
A1  - Bekele, Tolesa
A1  - Bell, Michelle L.
A1  - Bernabé, Eduardo
A1  - Beyene, Tariku J.
A1  - Bhutta, Zulfiqar
A1  - Bin Abdulhak, Aref
A1  - Blore, Jed D.
A1  - Basara, Berrak Bora
A1  - Bose, Dipan
A1  - Breitborde, Nicholas J. K.
A1  - Cárdenas, Rosario
A1  - Castañeda-Orjuela, Carlos A.
A1  - Castro, Ruben Estanislao
A1  - Catala-Lopez, Ferran
A1  - Cavlin, Alanur
A1  - Chang, Jung-Chen
A1  - Che, Xuan
A1  - Christophi, Costas A.
A1  - Chugh, Sumeet S.
A1  - Cirillo, Massimo
A1  - Colquhoun, Samantha M.
A1  - Cooper, Leslie Trumbull
A1  - Cooper, Cyrus
A1  - da Costa Leite, Iuri
A1  - Dandona, Lalit
A1  - Dandona, Rakhi
A1  - Davis, Adrian
A1  - Dayama, Anand
A1  - Degenhardt, Louisa
A1  - De Leo, Diego
A1  - Del Pozo-Cruz, Borja
A1  - Deribe, Kebede
A1  - Dessalegn, Muluken
A1  - deVeber, Gabrielle A.
A1  - Dharmaratne, Samath D.
A1  - Dilmen, Ugur
A1  - Ding, Eric L.
A1  - Dorrington, Rob E.
A1  - Driscoll, Tim R.
A1  - Ermakov, Sergei Petrovich
A1  - Esteghamati, Alireza
A1  - Faraon, Emerito Jose A.
A1  - Farzadfar, Farshad
A1  - Felicio, Manuela Mendonca
A1  - Fereshtehnejad, Seyed-Mohammad
A1  - de Lima, Graça Maria Ferreira
A1  - Forouzanfar, Mohammad H.
A1  - França, Elisabeth B.
A1  - Gaffikin, Lynne
A1  - Gambashidze, Ketevan
A1  - Gankpé, Fortuné Gbètoho
A1  - Garcia, Ana C.
A1  - Geleijnse, Johanna M.
A1  - Gibney, Katherine B.
A1  - Giroud, Maurice
A1  - Glaser, Elizabeth L.
A1  - Goginashvili, Ketevan
A1  - Gona, Philimon
A1  - González-Castell, Dinorah
A1  - Goto, Atsushi
A1  - Gouda, Hebe N.
A1  - Gugnani, Harish Chander
A1  - Gupta, Rahul
A1  - Gupta, Rajeev
A1  - Hafezi-Nejad, Nima
A1  - Hamadeh, Randah Ribhi
A1  - Hammami, Mouhanad
A1  - Hankey, Graeme J.
A1  - Harb, Hilda L.
A1  - Havmoeller, Rasmus
A1  - Hay, Simon I.
A1  - Pi, Ileana B. Heredia
A1  - Hoek, Hans W.
A1  - Hosgood, H. Dean
A1  - Hoy, Damian G.
A1  - Husseini, Abdullatif
A1  - Idrisov, Bulat T.
A1  - Innos, Kaire
A1  - Inoue, Manami
A1  - Jacobsen, Kathryn H.
A1  - Jahangir, Eiman
A1  - Jee, Sun Ha
A1  - Jensen, Paul N.
A1  - Jha, Vivekanand
A1  - Jiang, Guohong
A1  - Jonas, Jost B.
A1  - Juel, Knud
A1  - Kabagambe, Edmond Kato
A1  - Kan, Haidong
A1  - Karam, Nadim E.
A1  - Karch, André
A1  - Karema, Corine Kakizi
A1  - Kaul, Anil
A1  - Kawakami, Norito
A1  - Kazanjan, Konstantin
A1  - Kazi, Dhruv S.
A1  - Kemp, Andrew H.
A1  - Kengne, Andre Pascal
A1  - Kereselidze, Maia
A1  - Khader, Yousef Saleh
A1  - Khalifa, Shams Eldin Ali Hassan
A1  - Khan, Ejaz Ahmed
A1  - Khang, Young-Ho
A1  - Knibbs, Luke
A1  - Kokubo, Yoshihiro
A1  - Kosen, Soewarta
A1  - Defo, Barthelemy Kuate
A1  - Kulkarni, Chanda
A1  - Kulkarni, Veena S.
A1  - Kumar, G. Anil
A1  - Kumar, Kaushalendra
A1  - Kumar, Ravi B.
A1  - Kwan, Gene
A1  - Lai, Taavi
A1  - Lalloo, Ratilal
A1  - Lam, Hilton
A1  - Lansingh, Van C.
A1  - Larsson, Anders
A1  - Lee, Jong-Tae
A1  - Leigh, James
A1  - Leinsalu, Mall
A1  - Leung, Ricky
A1  - Li, Xiaohong
A1  - Li, Yichong
A1  - Li, Yongmei
A1  - Liang, Juan
A1  - Liang, Xiaofeng
A1  - Lim, Stephen S.
A1  - Lin, Hsien-Ho
A1  - Lipshultz, Steven E.
A1  - Liu, Shiwei
A1  - Liu, Yang
A1  - Lloyd, Belinda K.
A1  - London, Stephanie J.
A1  - Lotufo, Paulo A.
A1  - Ma, Jixiang
A1  - Ma, Stefan
A1  - Machado, Vasco Manuel Pedro
A1  - Mainoo, Nana Kwaku
A1  - Majdan, Marek
A1  - Mapoma, Christopher Chabila
A1  - Marcenes, Wagner
A1  - Marzan, Melvin Barrientos
A1  - Mason-Jones, Amanda J.
A1  - Mehndiratta, Man Mohan
A1  - Mejia-Rodriguez, Fabiola
A1  - Memish, Ziad A.
A1  - Mendoza, Walter
A1  - Miller, Ted R.
A1  - Mills, Edward J.
A1  - Mokdad, Ali H.
A1  - Mola, Glen Liddell
A1  - Monasta, Lorenzo
A1  - de la Cruz Monis, Jonathan
A1  - Hernandez, Julio Cesar Montañez
A1  - Moore, Ami R.
A1  - Moradi-Lakeh, Maziar
A1  - Mori, Rintaro
A1  - Mueller, Ulrich O.
A1  - Mukaigawara, Mitsuru
A1  - Naheed, Aliya
A1  - Naidoo, Kovin S.
A1  - Nand, Devina
A1  - Nangia, Vinay
A1  - Nash, Denis
A1  - Nejjari, Chakib
A1  - Nelson, Robert G.
A1  - Neupane, Sudan Prasad
A1  - Newton, Charles R.
A1  - Ng, Marie
A1  - Nieuwenhuijsen, Mark J.
A1  - Nisar, Muhammad Imran
A1  - Nolte, Sandra
A1  - Norheim, Ole F.
A1  - Nyakarahuka, Luke
A1  - Oh, In-Hwan
A1  - Ohkubo, Takayoshi
A1  - Olusanya, Bolajoko O.
A1  - Omer, Saad B.
A1  - Opio, John Nelson
A1  - Orisakwe, Orish Ebere
A1  - Pandian, Jeyaraj D.
A1  - Papachristou, Christina
A1  - Park, Jae-Hyun
A1  - Caicedo, Angel J. Paternina
A1  - Patten, Scott B.
A1  - Paul, Vinod K.
A1  - Pavlin, Boris Igor
A1  - Pearce, Neil
A1  - Pereira, David M.
A1  - Pesudovs, Konrad
A1  - Petzold, Max
A1  - Poenaru, Dan
A1  - Polanczyk, Guilherme V.
A1  - Polinder, Suzanne
A1  - Pope, Dan
A1  - Pourmalek, Farshad
A1  - Qato, Dima
A1  - Quistberg, Duane Alexander
A1  - Rafay, Anwar
A1  - Rahimi, Kazem
A1  - Rahimi-Movaghar, Vafa
A1  - ur Rahman, Sajjad
A1  - Raju, Murugesan
A1  - Rana, Saleem M.
A1  - Refaat, Amany
A1  - Ronfani, Luca
A1  - Roy, Nobhojit
A1  - Pimienta, Tania Georgina Sánchez
A1  - Sahraian, Mohammad Ali
A1  - Salomon, Joshua A.
A1  - Sampson, Uchechukwu
A1  - Santos, Itamar S.
A1  - Sawhney, Monika
A1  - Sayinzoga, Felix
A1  - Schneider, Ione J. C.
A1  - Schumacher, Austin
A1  - Schwebel, David C.
A1  - Seedat, Soraya
A1  - Sepanlou, Sadaf G.
A1  - Servan-Mori, Edson E.
A1  - Shakh-Nazarova, Marina
A1  - Sheikhbahaei, Sara
A1  - Shibuya, Kenji
A1  - Shin, Hwashin Hyun
A1  - Shiue, Ivy
A1  - Sigfusdottir, Inga Dora
A1  - Silberberg, Donald H.
A1  - Silva, Andrea P.
A1  - Singh, Jasvinder A.
A1  - Skirbekk, Vegard
A1  - Sliwa, Karen
A1  - Soshnikov, Sergey S.
A1  - Sposato, Luciano A.
A1  - Sreeramareddy, Chandrashekhar T.
A1  - Stroumpoulis, Konstantinos
A1  - Sturua, Lela
A1  - Sykes, Bryan L.
A1  - Tabb, Karen M.
A1  - Talongwa, Roberto Tchio
A1  - Tan, Feng
A1  - Teixeira, Carolina Maria
A1  - Tenkorang, Eric Yeboah
A1  - Terkawi, Abdullah Sulieman
A1  - Thorne-Lyman, Andrew L.
A1  - Tirschwell, David L.
A1  - Towbin, Jeffrey A.
A1  - Tran, Bach X.
A1  - Tsilimbaris, Miltiadis
A1  - Uchendu, Uche S.
A1  - Ukwaja, Kingsley N.
A1  - Undurraga, Eduardo A.
A1  - Uzun, Selen Begüm
A1  - Vallely, Andrew J.
A1  - van Gool, Coen H.
A1  - Vasankari, Tommi J.
A1  - Vavilala, Monica S.
A1  - Venketasubramanian, N.
A1  - Villalpando, Salvador
A1  - Violante, Francesco S.
A1  - Vlassov, Vasiliy Victorovich
A1  - Vos, Theo
A1  - Waller, Stephen
A1  - Wang, Haidong
A1  - Wang, Linhong
A1  - Wang, Xiaorong
A1  - Wang, Yanping
A1  - Weichenthal, Scott
A1  - Weiderpass, Elisabete
A1  - Weintraub, Robert G.
A1  - Westerman, Ronny
A1  - Wilkinson, James D.
A1  - Woldeyohannes, Solomon Meseret
A1  - Wong, John Q.
A1  - Wordofa, Muluemebet Abera
A1  - Xu, Gelin
A1  - Yang, Yang C.
A1  - Yano, Yuichiro
A1  - Yentur, Gokalp Kadri
A1  - Yip, Paul
A1  - Yonemoto, Naohiro
A1  - Yoon, Seok-Jun
A1  - Younis, Mustafa Z.
A1  - Yu, Chuanhua
A1  - Jin, Kim Yun
A1  - El Sayed Zaki, Maysaa
A1  - Zhao, Yong
A1  - Zheng, Yingfeng
A1  - Zhou, Maigeng
A1  - Zhu, Jun
A1  - Zou, Xiao Nong
A1  - Lopez, Alan D.
A1  - Naghavi, Mohsen
A1  - Murray, Christopher J. L.
A1  - Lozano, Rafael
SP  - 980
EP  - 1004
VL  - 384
IS  - 9947
N2  - BACKGROUND: The fifth Millennium Development Goal (MDG 5) established the goal of a 75% reduction in the maternal mortality ratio (MMR; number of maternal deaths per 100,000 livebirths) between 1990 and 2015. We aimed to measure levels and track trends in maternal mortality, the key causes contributing to maternal death, and timing of maternal death with respect to delivery. <br><br>METHODS: We used robust statistical methods including the Cause of Death Ensemble model (CODEm) to analyse a database of data for 7065 site-years and estimate the number of maternal deaths from all causes in 188 countries between 1990 and 2013. We estimated the number of pregnancy-related deaths caused by HIV on the basis of a systematic review of the relative risk of dying during pregnancy for HIV-positive women compared with HIV-negative women. We also estimated the fraction of these deaths aggravated by pregnancy on the basis of a systematic review. To estimate the numbers of maternal deaths due to nine different causes, we identified 61 sources from a systematic review and 943 site-years of vital registration data. We also did a systematic review of reports about the timing of maternal death, identifying 142 sources to use in our analysis. We developed estimates for each country for 1990-2013 using Bayesian meta-regression. We estimated 95% uncertainty intervals (UIs) for all values. <br><br>FINDINGS: 292,982 (95% UI 261,017-327,792) maternal deaths occurred in 2013, compared with 376,034 (343,483-407,574) in 1990. The global annual rate of change in the MMR was -0·3% (-1·1 to 0·6) from 1990 to 2003, and -2·7% (-3·9 to -1·5) from 2003 to 2013, with evidence of continued acceleration. MMRs reduced consistently in south, east, and southeast Asia between 1990 and 2013, but maternal deaths increased in much of sub-Saharan Africa during the 1990s. 2070 (1290-2866) maternal deaths were related to HIV in 2013, 0·4% (0·2-0·6) of the global total. MMR was highest in the oldest age groups in both 1990 and 2013. In 2013, most deaths occurred intrapartum or postpartum. Causes varied by region and between 1990 and 2013. We recorded substantial variation in the MMR by country in 2013, from 956·8 (685·1-1262·8) in South Sudan to 2·4 (1·6-3·6) in Iceland. <br><br>INTERPRETATION: Global rates of change suggest that only 16 countries will achieve the MDG 5 target by 2015. Accelerated reductions since the Millennium Declaration in 2000 coincide with increased development assistance for maternal, newborn, and child health. Setting of targets and associated interventions for after 2015 will need careful consideration of regions that are making slow progress, such as west and central Africa. FUNDING: Bill & Melinda Gates Foundation.<p />  <p>Language: en</p>
LA  - en
SN  - 0140-6736
UR  - http://dx.doi.org/10.1016/S0140-6736(14)60696-6
ID  - ref1
ER  -