Need for developing case definitions and guidelines for data collection, analysis, and presentation for maternal death as an adverse event following immunization:
Every year, there are at least 200 million women who become pregnant worldwide. Of these, approximately 585,000 women were reported to die each year as a result of pregnancy and childbirth related complications before the end of the second millennium by the WHO. More recent data suggest approximately a fifty percent decline in maternal deaths worldwide [1]. Although these statistics are encouraging, the death of a mother in itself is catastrophic and has a strong detrimental influence on not only the newborn, but the entire family leading to a vast emotional, psychosocial and economic vacuum. The exact number of women who die each year secondary to pregnancy is still unknown, especially since the majority of these events happen in remote rural areas globally. There is a universal problem with underreporting and misclassification of maternal deaths. In the USA, maternal death rate from 1982 to 1996 was actually 1.3 to 3 times the rate based solely on vital statistics data [2].
It is important to establish pregnancy status, timing and cause of death to define maternal death, but there exists considerable variation in identifying symptoms, signs, diseases and methods of deciphering and reporting cause of death. This in turn negatively affects global coding of maternal deaths.