Maternal mortality rate in Bao'an district, Shenzhen, China, 1999-2018

Abstract Background China had achieved impressive success in reducing maternal mortality rate (MMR), while substantial heterogeneity still existed, and reports from Shenzhen region remained a blank. This study aiming to use all available data sources to evaluate the MMR from 1999 to 2018 in Bao’an district, Shenzhen, China. Methods Data on maternal deaths and key health-service-related indicators were obtained from registration forms and Shenzhen Maternal and Child Health Management System. The levels and trends of MMR, profiles and leading causes of death, as well as results from the maternal mortality review committee were analyzed. Results The MMR in Bao’an district declined from 95.31 per 100,000 live births in 1999 to zero in 2018, with an annualized rate of decline of 12.03% per year. A significant declining trend of MMR was observed over 5-year intervals (from 82.61 to 5.22 per 100,000 live births). MMR was higher among migrant population, women aged ≥ 35 years or those who given birth outside the hospital. The first three causes of maternal death included hemorrhage (27.69%), amniotic fluid embolism (22.31%) and internal medical disease complications (15.38%). Nearly ninety percent (86.78%) of maternal deaths were determined to be preventable. Conclusions Bao’an district had experienced a fast decline in MMR for a two-decade period, its experience in lowering MMR could provide a guideline for other regions to focus on those who needed particular attention and take targeted interventions to reduce maternal deaths.