Impact of emerging virus pandemics on cause-specific maternal mortality time series: a population-based natural experiment using national vital statistics, Argentina 1980-2017

Background: Emerging pandemic viruses may have multiple deleterious effects on maternal health. This study examines the effects of a pandemic influenza virus on cause-specific maternal mortality time series, using Argentinian vital statistics. Methods: We conducted a population-based natural experim...

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Autores principales:	María Elena Critto, Yordanis Enriquez, Miguel Bravo, Lenin de Janon Quevedo, Ruth Weinberg, Adolfo Etchegaray, Elard S. Koch
Formato:	article
Lenguaje:	EN
Publicado:	Elsevier 2022
Materias:	Maternal Mortality Public Health Surveillance H1N1 Virus Pandemics Interrupted Time Series Analysis Argentina Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/89a6ac90fc894733b5a35b0dedbd3cec
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spelling	oai:doaj.org-article:89a6ac90fc894733b5a35b0dedbd3cec2021-12-02T05:04:42ZImpact of emerging virus pandemics on cause-specific maternal mortality time series: a population-based natural experiment using national vital statistics, Argentina 1980-20172667-193X10.1016/j.lana.2021.100116https://doaj.org/article/89a6ac90fc894733b5a35b0dedbd3cec2022-02-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2667193X21001125https://doaj.org/toc/2667-193XBackground: Emerging pandemic viruses may have multiple deleterious effects on maternal health. This study examines the effects of a pandemic influenza virus on cause-specific maternal mortality time series, using Argentinian vital statistics. Methods: We conducted a population-based natural experiment from national vital records of maternal deaths between 1980 and 2017. Joinpoint regression models were used to model time series of the maternal mortality ratio (MMR). The sensitivity of the registry to detect the effects of the pandemic H1N1 2009 influenza virus on cause-specific MMR was analysed using a panel of parallel interrupted time series (ITS). Findings: Over this 38-year study, the MMR decreased by 58·6% (69·5 to 28·8 deaths/100,000 live births), transitioning from direct obstetric causes (67·0 to 21·1/100,000 live births; 68·4% decrease) to indirect causes (2·6 to 7·7/100,000 live births; 196·2% increase). The regression analysis showed an average reduction of -2·2%/year (95% CI: -2·9 to -1·4) with 2 join points in the total trend (1998 and 2009). Parallel ITS analyses revealed the pandemic H1N1 virus had an increasing effect on mortality from the respiratory system- and sepsis-related complications (level change 4·7 and 1·6/100,000 live births respectively), reversing after the outbreak. No effect was found on MMR from hypertensive disorders, haemorrhage, abortive outcomes, other direct obstetric causes, and indirect non-respiratory comorbidities. Interpretation: The Argentinian maternal death registry appears sensitive to detect different effects of emerging infectious epidemics on maternal health. In a population-based natural experiment, pandemic H1N1 virus impacted maternal mortality almost exclusively from the respiratory system- and sepsis-related complications. Funding: Supported by FISAR www.fisarchile.orgMaría Elena CrittoYordanis EnriquezMiguel BravoLenin de Janon QuevedoRuth WeinbergAdolfo EtchegarayElard S. KochElsevierarticleMaternal MortalityPublic Health SurveillanceH1N1 VirusPandemicsInterrupted Time Series AnalysisArgentinaPublic aspects of medicineRA1-1270ENThe Lancet Regional Health. Americas, Vol 6, Iss , Pp 100116- (2022)
institution	DOAJ
collection	DOAJ
language	EN
topic	Maternal Mortality Public Health Surveillance H1N1 Virus Pandemics Interrupted Time Series Analysis Argentina Public aspects of medicine RA1-1270
spellingShingle	Maternal Mortality Public Health Surveillance H1N1 Virus Pandemics Interrupted Time Series Analysis Argentina Public aspects of medicine RA1-1270 María Elena Critto Yordanis Enriquez Miguel Bravo Lenin de Janon Quevedo Ruth Weinberg Adolfo Etchegaray Elard S. Koch Impact of emerging virus pandemics on cause-specific maternal mortality time series: a population-based natural experiment using national vital statistics, Argentina 1980-2017
description	Background: Emerging pandemic viruses may have multiple deleterious effects on maternal health. This study examines the effects of a pandemic influenza virus on cause-specific maternal mortality time series, using Argentinian vital statistics. Methods: We conducted a population-based natural experiment from national vital records of maternal deaths between 1980 and 2017. Joinpoint regression models were used to model time series of the maternal mortality ratio (MMR). The sensitivity of the registry to detect the effects of the pandemic H1N1 2009 influenza virus on cause-specific MMR was analysed using a panel of parallel interrupted time series (ITS). Findings: Over this 38-year study, the MMR decreased by 58·6% (69·5 to 28·8 deaths/100,000 live births), transitioning from direct obstetric causes (67·0 to 21·1/100,000 live births; 68·4% decrease) to indirect causes (2·6 to 7·7/100,000 live births; 196·2% increase). The regression analysis showed an average reduction of -2·2%/year (95% CI: -2·9 to -1·4) with 2 join points in the total trend (1998 and 2009). Parallel ITS analyses revealed the pandemic H1N1 virus had an increasing effect on mortality from the respiratory system- and sepsis-related complications (level change 4·7 and 1·6/100,000 live births respectively), reversing after the outbreak. No effect was found on MMR from hypertensive disorders, haemorrhage, abortive outcomes, other direct obstetric causes, and indirect non-respiratory comorbidities. Interpretation: The Argentinian maternal death registry appears sensitive to detect different effects of emerging infectious epidemics on maternal health. In a population-based natural experiment, pandemic H1N1 virus impacted maternal mortality almost exclusively from the respiratory system- and sepsis-related complications. Funding: Supported by FISAR www.fisarchile.org
format	article
author	María Elena Critto Yordanis Enriquez Miguel Bravo Lenin de Janon Quevedo Ruth Weinberg Adolfo Etchegaray Elard S. Koch
author_facet	María Elena Critto Yordanis Enriquez Miguel Bravo Lenin de Janon Quevedo Ruth Weinberg Adolfo Etchegaray Elard S. Koch
author_sort	María Elena Critto
title	Impact of emerging virus pandemics on cause-specific maternal mortality time series: a population-based natural experiment using national vital statistics, Argentina 1980-2017
title_short	Impact of emerging virus pandemics on cause-specific maternal mortality time series: a population-based natural experiment using national vital statistics, Argentina 1980-2017
title_full	Impact of emerging virus pandemics on cause-specific maternal mortality time series: a population-based natural experiment using national vital statistics, Argentina 1980-2017
title_fullStr	Impact of emerging virus pandemics on cause-specific maternal mortality time series: a population-based natural experiment using national vital statistics, Argentina 1980-2017
title_full_unstemmed	Impact of emerging virus pandemics on cause-specific maternal mortality time series: a population-based natural experiment using national vital statistics, Argentina 1980-2017
title_sort	impact of emerging virus pandemics on cause-specific maternal mortality time series: a population-based natural experiment using national vital statistics, argentina 1980-2017
publisher	Elsevier
publishDate	2022
url	https://doaj.org/article/89a6ac90fc894733b5a35b0dedbd3cec
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Impact of emerging virus pandemics on cause-specific maternal mortality time series: a population-based natural experiment using national vital statistics, Argentina 1980-2017

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