National, regional, and global levels and trends in maternal mortality between 1990 and 2015 with scenario-based projections to 2030: a systematic analysis by the United Nations Maternal Mortality Estimation Inter-Agency Group

作者：L. Alkema, D. Chou, D. Hogan, Sanqian Zhang, Ann-Beth Moller, A. Gemmill, Doris Ma Fat, T. Boerma, M. Temmerman, C. Mathers, L. Say, Saifuddin Ahmed, Mohamed M Ali, A. Amouzou, D. Braunholtz, P. Byass, Liliana Carvajal-Vélez, Victor Gaigbe-Togbe, P. Gerland, E. Loaiza, S. Mills, N. Mutombo, Holly Newby, T. Pullum, E. Suzuki · 发表于：The Lancet · 年份：2015 · DOI：10.1016/s0140-6736(15)00838-7 · 被引用次数：1557 · 研究领域：Medicine

Summary Background Millennium Development Goal (MDG) 5 calls for a reduction of 75% in the maternal mortality ratio (MMR) between 1990 and 2015. We estimated levels and trends in maternal mortality for 183 countries to assess progress made. Based on MMR estimates for 2015, we constructed scenario-based projections to highlight the accelerations needed to accomplish the Sustainable Development Goal (SDG) global target of less than 70 maternal deaths per 100,000 live births globally by 2030. Methods We updated the open access UN Maternal Mortality Estimation Inter-agency Group (MMEIG) database. Based upon nationally-representative data for 171 countries, we generated estimates of maternal mortality and related indicators with uncertainty intervals using a Bayesian model, which extends and refines the previous UN MMEIG estimation approach. The model combines the rate of change implied by a multilevel regression model with a time series model to capture data-driven changes in country-specific MMRs, and includes a data model to adjust for systematic and random errors associated with different data sources. Results The global MMR declined from 385 deaths per 100,000 live births (80% uncertainty interval ranges from 359 to 427) in 1990 to 216 (207 to 249) in 2015, corresponding to a relative decline of 43.9% (34.0 to 48.7) during the 25-year period, with 303,000 (291,000 to 349,000) maternal deaths globally in 2015. Regional progress in reducing the MMR since 1990 ranged from an ann...