Reproductive age mortality survey to study under-reporting of maternal mortality in Surinam

Objectives: A nationwide confidential enquiry into maternal deaths was carried out in Surinam during the years 1991-1993. Preliminary analysis showed a maternal mortality ratio (MMR) of 240 per 100 000 live births, which was almost four times higher than the official MMR for the preceding decade. The question arose whether maternal deaths had been under-reported for the years 1981-1990. For these 10 years official statistics revealed 65 maternal deaths. Methods: For the period 1981-1990 a retrospective reproductive age mortality survey was carried out in five urban hospitals covering 78% of all deliveries in Surinam. Results: In these hospitals 1216 women of age 10-49 years died. Due to disorganized filing 439 medical records (36%) could not be traced. By reviewing 64% of the records, 85 maternal deaths were identified (70 direct and 15 indirect). Conclusion: Although only 64% of medical records could be reviewed, the number of maternal deaths identified in five hospitals (85) was 1.3 times higher than the officially reported number for the whole country (65). Maternal mortality was found therefore to be under-reported in Surinam for the period 1981-1990. (C) 1998 Elsevier Science Ireland Ltd.