Women's Health: HIV-Related Mortality Rate Rising for Pregnant Women in South Africa

A recent study investigated maternal mortality at the Johannesburg Hospital, a 1,100-bed academic facility in South Africa. Physicians assessed patient records over two time periods: 1995-1996 and 2000-2001. "Causes of death were noted and compared with national data," wrote A.M. Kruger and coauthors. "The two time periods were compared to identify disease patterns and the role of anesthesia in maternal mortality."

The physicians found that maternal mortality ratios were respectively 183 and 354 per 100,000 live births. According to the report, hypertension in pregnancy was the leading cause of death in 1995-1996, accounting for 10 out of 20 deaths, but was the second most common cause of death in 2000-2001 (six out of 35).

"HIV/AIDS-associated disease was the leading cause of mortality in 2000-2001 (42.7 percent, increasing from 20 percent in 1995-1996) with pneumonia the commonest cause of death," study data showed. "The statistics at this hospital were consistent with the national trend of an increasing association with HIV/AIDS. No deaths were found to be directly attributable to anesthesia in either of the time periods," the researchers found.

The authors called for clearer documentation of HIV status in pregnancy and urged that doctors consider antiretroviral intervention strategies. The study, "HIV/AIDS: Impact on Maternal Mortality at the Johannesburg Hospital, South Africa, 1995-2001," appeared in the International Journal of Obstetric Anesthesia (2003; 12(3):164-168).

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