Abstract：Objective To evaluate the impact of Safe Motherhood Project on the maternal death in project counties in Guizhou Province. Methods Routinely reported data of maternal mortality and mortal death certificates in project counties in Guizhou Province were used to analyze the change of maternal death pattern. Results Since the implement of the Safe Motherhood Project, the hospital delivery rate in the project counties increased from 17.08% in 1999 to 98.48% in 2014. The maternal mortality dropped form 144.79/100,000 in 1999 to 29.44/100,000 in 2014.Hemorrhage, hypertensive disorders of pregnancy and amniotic fluid embolism had kept being the leading causes of maternal death. Since the hospital delivery rate was raised to >90% in 2010, the causes of maternal death had had important changes: proportions of maternal deaths due to postpartum hemorrhage and hypertensive disorders were decreased, and hepatic vein thrombosis and pulmonary thromboembolism got into the top five causes of maternal death. Retention of placenta and inertia of uterus had kept accounting for >60% of the causes of maternal hemorrhage. Since the incidence of retention of placenta decreased in 2010, inertia of uterus had been the leading cause of maternal hemorrhage.In 2010-2014, the hospital delivery rate was 97.56%.The overall maternal mortality ratio(MMR) was 26.64 deaths per 100,000 live births. The MMRs for home delivery and hospital delivery were respectively 136.30 and 14.69 deaths per 1000,000 live births. Conclusions The maternal mortality ratio kept decreasing from 1999 to 2014 in Safe Motherhood Project counties in Guizhou Province. The decline of deaths from avoidable causes such as hemorrhage and hypertensive disorders was more evident. The main influential factors of MMR was hospitalized delivery. More effort is needed to increase the hospital delivery rate in rural, particularly in poor rural areas in Guizhou.
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