Trend and causes of maternal death, stillbirth and neonatal death over seven decades in Hong Kong
Summary: Background: Reducing maternal and perinatal mortality is a global objective. Hong Kong is a city with low maternal and perinatal mortality but little is known about the trend and causes of these deaths in this high-income city. We analyzed the maternal death, stillbirth and neonatal death...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2022-09-01
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| Series: | The Lancet Regional Health. Western Pacific |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666606522001389 |
| _version_ | 1818536039828946944 |
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| author | Ka Wang Cheung Mimi Tin Yan Seto Weilan Wang Chi Tao Ng William Wing Kee To Ernest Hung Yu Ng |
| author_facet | Ka Wang Cheung Mimi Tin Yan Seto Weilan Wang Chi Tao Ng William Wing Kee To Ernest Hung Yu Ng |
| author_sort | Ka Wang Cheung |
| collection | DOAJ |
| description | Summary: Background: Reducing maternal and perinatal mortality is a global objective. Hong Kong is a city with low maternal and perinatal mortality but little is known about the trend and causes of these deaths in this high-income city. We analyzed the maternal death, stillbirth and neonatal death since 1946 in Hong Kong. Methods: Data were extracted from vital statistics, based on the number of registered deaths and births, provided by the Department of Health, the Government of the HKSAR. The annual change rate of mortality was evaluated by regression analysis. Contextual factors were collected to assess the association with mortality. Findings: Between 1946 and 2017, the stillbirth rate (per 1,000 total births) reduced from 21·5 to 2·4; early and late neonatal deaths (per 1,000 live births) reduced from 14·1 and 18·1 to 0·7 and 0·4 in 2017, respectively. The maternal mortality ratio (per 100,000 live births) declined from 125 to 1·8.The causes of maternal and perinatal deaths were available since 1981 and 1980 respectively. The leading causes of death were thromboembolism (37·0%) and obstetric haemorrhage (30·4%) for maternal death; congenital problem (30·1%) and prematurity (29·0%) for neonatal death. No data on causes of stillbirth were available. No specific shift of pattern was observed in the causes of maternal and neonatal death with time. There were no cases of maternal death due to sepsis and only 2 cases (2·2%) of maternal deaths due to indirect cause. Interpretation: The maternal and perinatal death have reduced significantly in Hong Kong and maintained at the lowest level globally. Indirect maternal death and sepsis were unusual causes of maternal deaths. Use of ICD-PM stillbirth classification, setting up a maternal death confidential enquiry and adding pregnancy checkbox could be the next step to identify and categorize hidden burden. Funding: Nil. |
| first_indexed | 2024-12-11T18:32:51Z |
| format | Article |
| id | doaj.art-bfbb596dc1a543d69f1b38bf6ac9d725 |
| institution | Directory Open Access Journal |
| issn | 2666-6065 |
| language | English |
| last_indexed | 2024-12-11T18:32:51Z |
| publishDate | 2022-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | The Lancet Regional Health. Western Pacific |
| spelling | doaj.art-bfbb596dc1a543d69f1b38bf6ac9d7252022-12-22T00:54:52ZengElsevierThe Lancet Regional Health. Western Pacific2666-60652022-09-0126100523Trend and causes of maternal death, stillbirth and neonatal death over seven decades in Hong KongKa Wang Cheung0Mimi Tin Yan Seto1Weilan Wang2Chi Tao Ng3William Wing Kee To4Ernest Hung Yu Ng5Department of Obstetrics and Gynaecology, Queen Mary Hospital, the University of Hong Kong, Hong Kong SAR, China; Corresponding author at: MRCOG, 6/F, Professorial Block, Queen Mary Hospital, 102 Pokfulam Road, Hong Kong SAR, China.Department of Obstetrics and Gynaecology, Queen Mary Hospital, the University of Hong Kong, Hong Kong SAR, ChinaDepartment of Obstetrics and Gynaecology, Queen Mary Hospital, the University of Hong Kong, Hong Kong SAR, ChinaClinical Trials Centre, The University of Hong Kong, Hong Kong SAR, ChinaDepartment of Obstetrics and Gynaecology, United Christian Hospital, Hong Kong SAR, ChinaDepartment of Obstetrics and Gynaecology, Queen Mary Hospital, the University of Hong Kong, Hong Kong SAR, ChinaSummary: Background: Reducing maternal and perinatal mortality is a global objective. Hong Kong is a city with low maternal and perinatal mortality but little is known about the trend and causes of these deaths in this high-income city. We analyzed the maternal death, stillbirth and neonatal death since 1946 in Hong Kong. Methods: Data were extracted from vital statistics, based on the number of registered deaths and births, provided by the Department of Health, the Government of the HKSAR. The annual change rate of mortality was evaluated by regression analysis. Contextual factors were collected to assess the association with mortality. Findings: Between 1946 and 2017, the stillbirth rate (per 1,000 total births) reduced from 21·5 to 2·4; early and late neonatal deaths (per 1,000 live births) reduced from 14·1 and 18·1 to 0·7 and 0·4 in 2017, respectively. The maternal mortality ratio (per 100,000 live births) declined from 125 to 1·8.The causes of maternal and perinatal deaths were available since 1981 and 1980 respectively. The leading causes of death were thromboembolism (37·0%) and obstetric haemorrhage (30·4%) for maternal death; congenital problem (30·1%) and prematurity (29·0%) for neonatal death. No data on causes of stillbirth were available. No specific shift of pattern was observed in the causes of maternal and neonatal death with time. There were no cases of maternal death due to sepsis and only 2 cases (2·2%) of maternal deaths due to indirect cause. Interpretation: The maternal and perinatal death have reduced significantly in Hong Kong and maintained at the lowest level globally. Indirect maternal death and sepsis were unusual causes of maternal deaths. Use of ICD-PM stillbirth classification, setting up a maternal death confidential enquiry and adding pregnancy checkbox could be the next step to identify and categorize hidden burden. Funding: Nil.http://www.sciencedirect.com/science/article/pii/S2666606522001389DeathMortalityMaternalNeonatalStillbirthThromboembolism |
| spellingShingle | Ka Wang Cheung Mimi Tin Yan Seto Weilan Wang Chi Tao Ng William Wing Kee To Ernest Hung Yu Ng Trend and causes of maternal death, stillbirth and neonatal death over seven decades in Hong Kong The Lancet Regional Health. Western Pacific Death Mortality Maternal Neonatal Stillbirth Thromboembolism |
| title | Trend and causes of maternal death, stillbirth and neonatal death over seven decades in Hong Kong |
| title_full | Trend and causes of maternal death, stillbirth and neonatal death over seven decades in Hong Kong |
| title_fullStr | Trend and causes of maternal death, stillbirth and neonatal death over seven decades in Hong Kong |
| title_full_unstemmed | Trend and causes of maternal death, stillbirth and neonatal death over seven decades in Hong Kong |
| title_short | Trend and causes of maternal death, stillbirth and neonatal death over seven decades in Hong Kong |
| title_sort | trend and causes of maternal death stillbirth and neonatal death over seven decades in hong kong |
| topic | Death Mortality Maternal Neonatal Stillbirth Thromboembolism |
| url | http://www.sciencedirect.com/science/article/pii/S2666606522001389 |
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