Two-thirds of maternal deaths are caused by an unrelated medical or mental health condition that has not been well-controlled rather than from a complication of pregnancy, according to a report from the Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries across the UK (MBRRACE-UK) programme
According to the report, 321 women died during pregnancy or within the first six weeks after giving birth in the UK between 2009 and 2012 because of a pregnancy complication or another health condition. Nearly three-quarters of the women who died had a pre-existing medical or mental health condition.
“It was clear that several women had stopped taking their medications when they got pregnant. Their illness then became worse and in some cases this was a direct cause of their death,” says Marian Knight, one of the authors of the report and professor of maternal and child population health at the National Perinatal Epidemiology Unit, University of Oxford. “It is really important that women with pre-existing medical or mental health conditions get good pre-pregnancy care because that allows them to discuss their medicines and plan which ones are best to continue taking when they are pregnant.”
A woman with a pre-existing medical or mental health condition who finds herself pregnant unexpectedly should see her doctor as soon as possible, and not stop taking any medicines unless her doctor advises her to, she adds.
A total of 29 of the maternal deaths (deaths during or within six weeks of the end of pregnancy) were due to influenza, and another seven women died from flu in the following few months. Almost two-thirds of these flu deaths occurred after the flu vaccine was routinely offered to pregnant women in the UK.
“To avoid preventable deaths, the benefits of influenza vaccination to pregnant women should be promoted and pregnant women at any stage of pregnancy should be offered vaccination,” the report says.
The latest flu vaccination data from Public Health England show that 38.3% of pregnant women had received this season’s flu vaccine by the beginning of December 2014.
 Knight M, Kenyon S, Brocklehurst P et al (Eds.) on behalf of MBRRACE-UK. Saving lives, improving mothers’ care - Lessons learned to inform future maternity care from the UK and Ireland Confidential Enquiries into Maternal Deaths and Morbidity 2009–12. Oxford: National Perinatal Epidemiology Unit, University of Oxford. December 2014.