Maternal Deaths and Mortality Due to a Maternal Underlying Cause of Death

It is necessary to distinguish 'maternal deaths' from 'deaths due to maternal causes', as underlying causes, when measuring maternal mortality. World Health Organization-WHO-defines maternal deaths as those occurred during pregnancy and until 42 days of puerperium, and maternal causes like all deaths classified in Chapter XV of Statistical Classification of Diseases and Related Health Problems, 10th Revision-ICD-10th Revision-, including even those occurred after 42 days of postpartum. Some results of the investigation of women in childbearing age-10 to 49 years old-deaths, residents in Brazilian capitals and the Federal District in 2002, are discussed. The RAMOS methodology was adopted. Comparing the underlying causes of the original death certificates with those filled after the household interview and consulting of hospital records, 15.9% of deaths due to maternal causes were not maternal deaths in fact, according to WHO definition; there was also a sub-enumeration of maternal deaths. It is recommended to improve the filling of death certificate by physicians, and inclusion of new categories in the ICD-10th Revision, regarding maternal causes.