Suicides and cardiovascular diseases are the leading causes of maternal death in France.
- Cardiovascular diseases were responsible for 36 deaths between 2013 and 2015, or 13.7% of maternal deaths.
- Suicide has become the second cause of maternal mortality over the same period, with 35 suicides (about 1 per month), or 13.4% of maternal deaths.
Pregnancy and the birth of a child are associated with happy times in life. And yet, suicide is the second leading cause of maternal mortality, just behind cardiovascular disease, according to a new survey by Public Health France and Inserm.
87 women die per year from pregnancy-related causes
A maternal death corresponds to the death of a woman occurring during pregnancy and up to 1 year after childbirth. 262 maternal deaths were identified between 2013 and 2015 in France (1 every 4 days on average), which represents 87 women who died per year from a cause related to pregnancy, childbirth or their consequences. The maternal mortality ratio (MMR), which is 10.8 deaths per 100,000 live births, is stable compared to the two previous monitoring periods (2010-2012 and 2007-2009), and is within the European average.
Cardiovascular diseases were responsible for 36 deaths between 2013 and 2015, or 13.7% of maternal deaths. Suicide has become the second cause of maternal mortality over the same period, with 35 suicides (about 1 per month), or 13.4% of maternal deaths. The main risk factors for maternal death are the advanced age of the mother, her overweight, a difficult social situation and her migratory route. Concerning suicide more particularly, women are psychologically more fragile during pregnancy and after childbirth, with a high risk of pre-partum and post-partum depression (much more serious than the famous “baby blues”).
58% of deaths are considered “preventable”
Two areas are distinguished by a higher level of maternal mortality (RMM), a disparity already present in the previous report: the overseas departments and Île-de-France. Women residing in the overseas departments present a risk of maternal mortality multiplied by 4 compared to those in mainland France. More surprisingly, in mainland France, Île-de-France stands out with an MMR 55% higher than that of all the other regions.
According to the survey, in 66% of cases, the care provided was not optimal and 58% of deaths are considered “avoidable” Where “possibly avoidable” by improving prevention, the organization of care and the care itself. A committee of experts has therefore formulated 30 key messages intended for health professionals, women, their families and decision-makers by targeting elements to be improved, of which we can cite the most general:
• the importance of the non-strictly obstetrical medical examination of pregnant women and the search for psychiatric and addictological antecedents, as well as their potential social vulnerability.
• The evaluation of the risks of complications before conception and at the start of pregnancy, which should allow planning of the management of the individualized pregnancy.
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