Differences in Maternal Mortality between Urban and Rural Areas: Analysis of Maternal Mortality based in Jinan, China in 1995-2018

Background: Although a large number of studies have shown that maternal mortality in rural areas is higher than that in urban areas, few reports discussed the detailed situation and the behind causes. Here, we summarized the maternal mortality from 1995 to 2018 in Jinan, a city in Eastern China, and the reason behind it was deeply discussed. It is expected to reveal the difference and it’s behind reasons, thus providing a basis for policymakers to develop interventions.

Methods: Data about maternal mortality in the selected city from 1995 to 2018 were collected through the local maternal and child health care network. Maternal death age, maternal death delivery location, maternal death location, number of pregnancies, number of deliveries and maternal death causes were analyzed. The composition ratio of the above factors was compared in order to indicate the differences between rural areas and urban areas.

Result: The study showed that 75.34% of maternal deaths in urban areas occurred in tertiary hospitals, which were 2.13 times higher than those in rural areas (p<0.05). 16.67% of maternal deaths in rural areas delivered in primary hospitals, which were 12.17 times higher than those in urban areas (p<0.05). The main cause of death in rural areas was attributed to direct obstetric reasons, which were indirect obstetric reasons for urban areas (p<0.05). There was no difference in maternal deaths in the death age, number of births, and number of pregnancies between rural areas and urban areas (p>0.05).

Conclusion: Policymakers should focus on the construction of medical institutions in rural areas, the improvement of rescue capabilities in rural areas and the convenience of transport in rural areas in order to narrow the gap between rural and urban areas.