| Summary: | Objective: This study examined the extent to which maternal mortality in Taiwan is underreported in officially published mortality statistics.
Materials and methods: We used National Health Insurance claims data collected from two million samples, which were linked with the officially published mortality data, to identify women aged 15–49 years, who were admitted to a hospital with pregnancy-related diagnoses during 2000–2009 and died during the pregnancy or within 42 days after the termination of pregnancy.
Results: Based on these linked data, we identified 26 maternal deaths, only nine of which were reported in the original officially published mortality data; thus, the rate of underreporting was 65% [(26 − 9)/26]. The revised maternal mortality ratio was 14.1 deaths per 100,000 live births (95% confidence interval: 8.7–19.5), which was approximately three times higher than the official reported ratio of 4.9 (95% confidence interval: 1.7–8.1). The most common cause of maternal deaths was amniotic fluid embolism (n = 10), followed by eclampsia and preeclampsia (n = 4).
Conclusion: Approximately two-thirds of the maternal deaths in Taiwan were unreported in the officially published mortality data. Hence, routine nationwide data linkage is essential to monitor maternal mortality in Taiwan accurately.
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