Assessment of Maternal Mortality Rate and Associated Risk Factors at Tertiary Hospitals in Burundi (2020-2021): A retrospective Cohort Study

Background: Burundi continues to struggle with maternal mortality (MM). Early risk factor identification is crucial for thorough intervention measures to be developed to prevent pregnancy-related problems. Objective: To investigate maternal mortality rate (MMR) and identify its associated risk factors among women aged 15 to 49 years at four tertiary hospitals in Burundi. Methods: We collected data describing all pregnancies from January 2020 to December 2021 among women enrolled in Centre Hospital-University of Kamenge (CHUK), Military Hospital of Kamenge (MHK), Prince Regent Charles Hospital (PRCH), and Clinical Hospital Prince Louis Rwagasore (CHPLR) referral hospitals. We reported the proportion of mothers who died per pregnancy and the MMR. Multivariate regression models were used to determine the maternal, pregnancy-related, delivery, and postpartum factors that were associated with maternal death. Results: There were 31,968 deliveries in total in CHUK, MHK, PRCH, and CHPLR referral hospitals, 125 of which resulted in maternal fatalities. The total live births were 31,067, yielding an MMR of 402/100,000 live births. Our findings suggest significant associations between MMR and direct and indirect causes of maternal death, (F (8, 116) = 2.18, p < .05); haemorrhage and uterine rupture, where p was less than 0.05; community-level characteristics, (F (7, 117) = 9.91, p < .05); and type of delay, (F (3, 121) = 2.76, p < .05). Whereas, second delay was significantly associated with MMR, with p = 0.005. Conclusion: Reducing maternal fatalities in CHUK, MHK, PRCH, and CHPLR requires the implementation of ANC programs on the management of obstetric problems.