3054.0: Monday, October 22, 2001 - Board 9

Abstract #23207

Maternal Mortality Among Palestine Refugee

Haifa Husni Madi, MD MPH, Health Department/Family Health, UNRWA Headquarters Amman, P.O. BOX 140157, Amman 11814, Amman- Jordan, Jordan, + 962 79 516547, hmadi@cstamman.org.jo

The maternal mortality rate among Palestinian refugees residing in Lebanon, Gaza, Syria, Jordan and the West Bank was reported to be 26 deaths per 100,000 livebirths in 1999. In order to better understand causes of maternal deaths and introduce preventive measures, we reviewed all medical records and verbal autopsy reports of all 84 maternal deaths, which were reported during the period 1995-1999. We found high proportions of maternal deaths to be primigravida (21.4%), having 6 or more children (26.2%), 35 years of age or more (36.9%), and those having <5 years of education (53.8%). The leading causes of maternal deaths were pre-eclampsia (25.6%), hemorrhage (23.3%), pulmonary embolism (14.6%), and septicemia (5.3%). There was a strong association between the occurrence of pre-eclampsia and age at death. Deaths due to pre-eclampsia were high among women 35 years of age or more (38.1%). Deaths due to pre-eclampsia were high among primigravidas (33.3%), as well as among mothers with more than 6 children (38.1%). Hemorrhage was significantly higher among mothers who have more than 6 children (26.3%) and mothers who are 35 years of age and above (42.1%).

Based on these findings, new standards have been introduced to better care for women, particularly for the early diagnosis and management of pre-eclampsia. These standards included competency-based training of all health staff on proper and accurate BP measurement, Medical Officers should measure and record BP of all pregnant women during first pre-natal visits and Gyn/Obst should measure BP of all high-risk women during follow-up visits.

Learning Objectives: 1.Identify causes of maternal deaths in order to be addressed for further reduction 2. Analyze causes of deaths and its associattion with age, parity and education

Keywords: Refugees,

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Since 1950, the United Nations Relief and Work Agency for Palestine refugees in the Near East (UNRWA)has provided education, health, and relief and social services to registered Palestinian refugees in Jordan, Gaza,the West Bank, Lebanon and Syria (estima
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

The 129th Annual Meeting of APHA