Link Between Maternal Mortality & HIV “Laid Bare”. 12/4/10

The Lancet today published a new analysis of maternal mortality data, in which the authors document greater progress in reducing maternal deaths than previous examinations. They also highlight the role of HIV in preventing even more significant gains in saving mother’s lives.

The authors estimate there were 342,900 maternal deaths globally in 2008, down from about 526,300 in 1980. Subtract HIV from the equation, they write, and there would have been 281,500 maternal deaths in 2008. The on-the-ground implications: more pregnant women and new mothers should be given access to ARVs.

“Our analysis, in line with previous studies, draws attention to the important adverse effect of the HIV epidemic on the MMR [maternal mortality ratio], especially in east and southern Africa,” write Dr. Christopher Murray, of the Institute for Health Metrics and Evaluation at the University of Washington, and colleagues. “In the absence of HIV, progress in sub-Saharan Africa in reducing the MMR would have been much more extensive than we recorded. The counterfactual analysis of the MMR without HIV-related deaths has important implications for intervention policy. The set of interventions for dealing with HIV infection in pregnant or post-partum women would include access to antiretroviral drugs, which is not part of the set of maternal health interventions targeting women who are HIV negative.”

In an accompanying editorial, the Lancet writes that “HIV has been a major cause of paralysis” in improving maternal mortality and this study exposes “the intimate connection between HIV and maternal health.”

Hopefully this connection will not be lost on key policymakers, as maternal mortality gets increased attention from the White House and others in the U.S. government.