Unveiling the Determinants of Maternal Mortality: Sociodemographic Profile, Causes, and Systemic Delays in Eastern Uttar Pradesh—A Retrospective Study

Introduction: Motherhood is the most cherished experience in a woman's life, but it can also be marked by significant stress, hardship, and, in some cases, death.In 2023 alone, approximately 2,60,000 women died due to pregnancy-and childbirth-related issues.India recorded a Maternal Mortality Ratio (MMR) of 88 in 2022, with Uttar Pradesh being the second-highest with an MMR of 141.Objective: To determine the MMR, to identify the sociodemographic factors and causes related to maternal mortality, and to suggest strategies to reduce maternal deaths.Methods: This retrospective study was conducted over a period of 2 years from January 1, 2023, to December 31, 2024, at a tertiary care medical college in Uttar Pradesh (UP).Data were collected from the patient record files and maternal death review forms.The collected data were analyzed on the basis of the following parameters, including age, parity, residence, socio-economic status, antenatal visits, referral, status on hospital admission, admission to death duration, mode of delivery, and cause of death.Results: A total of 233 maternal deaths were analyzed over the study period.The Maternal Mortality Ratio during the study period was 2,275.9 in 2023 and 2,084.4 in 2024.The majority of maternal deaths were in the 20-30 years age group (85%), lower socio-economic status (70.8%), belonged to rural areas (78%), and had suboptimal antenatal visits (43.8%).95% deceased women were referred, 81% were vitally unstable at the time of admission, and 54% died within 48 hours of admission.Severe anemia was prevalent in 40.3% of deceased women.Direct causes accounted for 90.6% of deaths, with hypertensive disorders being the leading cause (40.8%), followed by hemorrhage (28.8%).Indirect causes accounted for 9% of deaths, with cardiac disease (5%) being the most common indirect cause.Type I delay was observed in 73% women, type II delay in 18.5% and type III delay in 8.5% women.Conclusion: Maternal mortality is driven by both clinical and systemic factors.While addressing medical causes like hypertension and hemorrhage is essential, equal focus is needed on improving female literacy, antenatal care, timely care-seeking behavior, referral systems, and strengthening health infrastructure and staffing, particularly in peripheral areas.