Maternal mortality rate

Definition

The maternal mortality definition by WHO is maternal death as the death of a pregnant person due to complications related to pregnancy, underlying conditions worsened by the pregnancy or management of these conditions. This can occur either while the person is pregnant or within six weeks of resolution of the pregnancy.

The maternal mortality in MOPH of Thialand is defined by all cause pregnancy mortallity that include both direct and indirect cause of death.

The maternal mortality rate is the maternal mortality in the period time usuallly used per year.

How to calculate?

The numerator is sum of cases of maternal death, The dominator is sum of pregnancy case in period time.

Main usefulness.

The main usefulness of this vital statistics is to compare the incidence of maternal mortality to show the healthcare services. When the incidence was increased, the cause of problem must be explored and the intervention must be provided to reduce the maternal mortality rate.

Case-Fatality rate

Definition
Generally, the case fatality ratio (CFR) is the proportion of individuals diagnosed with a disease who die from that disease and is, therefore, a measure of severity among the detected cases.

How to calculate?
This metric is calculated by dividing the total number of deaths from the disease by the total number of infected individuals; hence, in contrast to the CFR, the IFR incorporates asymptomatic and undiagnosed infections as well as reported cases.

Main usefulness.
CFR can be used to assess the deadliness of an outbreak and evaluate any implemented public health measures are generally obtained at the end of an outbreak after all cases have been resolved.

Case-Fatality rate
Definition
It is proportion of death cases from a specific disease among all diagnosed cases of the disease over a certain period of time.
How to calculate
To measure this statistic, numerator is number of death cases from a specific disease whereas denominator is all diagnosed cases of this specific disease.
Main usefulness
Case fatality rate tend to be used to measure severity of acute infectious disease rather than chronic disease with longer duration. This is because accuracy of both nominator and denominator can be affected by length of the disease in which a person can die from other disease rather than the specific disease that we are interested.

Mortality rate

Definition:

Mortality Rate is a measure of the number of deaths (in general, or due to a specific cause) in a particular population, scaled to the size of that population, per unit of time. There are several types of mortality rate, each providing us with different data and informing us of the risks associated with various states. The main ones are:

• Crude mortality rate – The most general type as it refers to all causes of death. Generally, it’s used to compare the living conditions of certain periods or populations as it’s been found that death rates decrease in developed countries. It also tells us what factors are especially crucial to our well-being.

• Specific death rates – These can be age, cause, race, or sex-specific. They provide more detailed data, allowing us to focus on reducing the impact of the most deadly factors, for instance, by producing vaccines.

• Infant, post neonatal, and neonatal mortality rates – These are particular age-specific cases. They cover different time intervals:
o Neonatal – From birth up to the first 28 days (excluding exactly 28 days);
o Post neonatal – From 28 days of age up to 1 year of age (excluding exactly 1 year);
o Infant – A sum of the above two, so it covers the time from birth up to 1 year (excluding exactly 1 year).

• Maternal death rate – Another specific type as it deals only with women deceased during pregnancy or within 42 days of termination. It may be tricky to calculate as it excludes deaths caused by incidents unrelated to this state. It’s another way of comparing the medical development of countries or periods; it also tells us what conditions may increase risks related to childbirth (e.g., age).

• Combined mortality rate – A mixture of the specific rates often used in research. An instance could be the breast cancer mortality rate among women aged 35-79. This is age, cause, and sex-specific.

• Age-adjusted death rate – A standardized and more objective rate. Mortality increases with age, so if we simply compared an older society (such as Japanese with a median age of 48.6) with a younger one (e.g., the USA with a median age of 38.1), we’d find that the former has higher mortality rate. To eliminate such distortions, the values are adjusted using various statistical techniques, resulting in the age-adjusted death rate.

Calculation:

The crude death rate formula can be expressed as:
death rate = deaths / population * 10n,
where,
deaths – Deaths measured within specified time interval for a certain population;
n – The exponent and gives you the answer per every 10n people.

Infant mortality rate calculation:
infant mortality rate = deaths among children / live births * 10n,
where both deaths among children and live births are measured within the same time period. This formula is valid for infant, post neonatal, and neonatal mortality rates.

Maternal mortality ratio calculation:
maternal mortality rate = deaths during pregnancy / live births * 10n,
where both variables are measured over the same time interval, and deaths during pregnancy include those that happened within 42 days of its termination.

Main usefulness:
The mortality rate is used mainly in epidemiology. It helps estimate the mortality risk, identifies potential threats, and gives statistics about the population.

Maternal mortality rate

Definition : The maternal mortality rate is a rate of death of women wile pregnant or within 42 days after pregnancy termination due to causes related to or aggravated by the pregnancy or pregnancy management, but not from accidental or incidental cause.

Calculation: The maternal mortality rate is calculated from the number of maternal death divided by the women years of exposure for women in the interested time and population.

Usefulness: The maternal mortality rate able to captures the likelihood of both becoming pregnant and dying during pregnant. The indicator can reflects the capacity of health system to effectively prevent and address the complications that able occur during pregnancy period.

I would like to select Neonatal mortality rate

Definition
NEONATAL MORTALITY RATE is the number of resident newborns in a specified geographic area (country, state, county, etc.) dying at less than 28 days of age divided by the number of resident live births for the same geographic area (for a specified time period, usually a calendar year) and multiplied by 1,000.

Calculation
(Number of resident neonatal deaths/Number of resident live births) x 1,000

Usefulness
The main purpose of this vital statistic is to determine rate of survival of fetal. In under-development countries, the rate is high since access to medical service is scarce. By improving to maternal care can help reduce fetal motility rates.

“Infant mortality rate”

Definition
Infant mortality is the death of an infant before his or her first birthday.Causes of Infant Mortality are five leading causes of infant death were:
– Birth defects.
– Preterm birth and low birth weight.
– Injuries (e.g., suffocation).
– Sudden infant death syndrome.
– Maternal pregnancy complications.
and etc.
In addition to giving us key information about maternal and infant health, the infant mortality rate is an important marker of the overall health of a society.

Calculation
(Number of resident infant deaths/Number of resident live births) x 1,000
Exp.
1,300 infant deaths in 2021 among state residents
150,000 live births in 2021 to state residents
1,300/150,000 x 1,000 = 8.7 infant deaths per 1,000 live births in 2022 among state residents

Usefulness
IMR remains an important indicator of health for whole populations, reflecting the intuition that structural factors affecting the health of entire populations have an impact on the mortality rate of infants.

Age-specific mortality rate
Definition
An age-specific mortality rate is a mortality rate limited to a particular age group.

Calculation
The numerator is the number of deaths in that age group; the denominator is the number of persons in that age group in the population. For example, in the United States in 2003, a total of 130,761 deaths occurred among persons aged 25–44 years, or an age-specific mortality rate of 153.0 per 100,000 25–44 year olds.

Usefulness
Age-adjusted rates allow you to compare health statistics (like death rates) between population groups, even though the size of the groups or the age of group members might be very different.

Neonatal mortality rate
Definition
Neonatal mortality rate is rate of child deaths in first 28 days after they born per 1000 live births in period or specific year.

Calculation
Numerator is number of children who died in first 28 days after birth in period or specific year.
Denominator is number of live births in period or specific year.
Calculate: Numerator divided by denominator and multiplied by 1000.

Usefulness
Neonatal mortality associated with mother’s quality of live before they delivered a child. This is vital statistic can used to planning health system and policy for pregnant women health.

Mortality Rate

Definition
A mortality rate is a measure of the frequency of occurrence of death in a defined population during a specified interval.
It is typically expressed in units of deaths per 1,000 individuals per year

Calculation

Mortality Rate = [Deaths occurring during a given time period (typically 1 year) / Size of the population among which
the deaths occurred ] x 1000 (in case of expressed in units of deaths per 1,000 individuals)

Main usefulness
Mortality data allow health authorities to evaluate how they prioritize public health programs. It can be used to compare the rates in one area with the rates in another area, or to compare rates over time.

Fetal Death Rate
-Definition
the number of resident fetal deaths in a specified geographic area (country, state, county, etc.) divided by the number of resident live births plus fetal deaths for the same geographic area (for a specified time period, usually a calendar year) and multiplied by 1,000.

-Calculation
(Number of resident fetal deaths/Number of resident live births + Number of resident fetal deaths) x 1,000

-Main Usefulness
to determine the rate of fetal death and evaluate the public health programs

Case-fatality rate

• Definition:
The proportion of people who die from disease among all individuals who also got the disease over a certain period.

• Calculation:
CFR in % = Number of people die from the disease / Number of confirmed cases of the disease x 100

• Usefulness:
CFR is used as a measure for disease severity. The number of CFR may change depending on the population, time/period, or treatment change.

INFANT MORTALITY RATE
1. Definition
INFANT MORTALITY RATE is the number of resident newborns in a specified geographic
area (country, state, county, etc.) dying under one year of age divided by the number of resident
live births for the same geographic area (for a specified time period, usually a calendar year) and
multiplied by 1,000.

2. How to calculate each vital statistic?
(Number of resident infant deaths/Number of resident live births) x 1,000

3. What are the main usefulness of each vital statistic?
High infant mortality rates are generally indicative of unmet human health needs in sanitation, medical care, nutrition, and education. The infant mortality rate is an age-specific ratio used by epidemiologists, demographers, physicians, and social scientists to better understand the extent and causes of infant deaths.

Case Fatality Rate
The case fatality rate is abbreviated as CFR. It interprets the severity of the disease and as it is the proportion, it is expressed in percentage.
The numerator is the number of deaths and the denominator is the number of disease cases multiplied by 100.

Mortality rate is the ratio of death events in a particular population during a specific time period. The rate was usually calculated per 1000 or 100,000 individuals.

Calculation: Mortality Rate = (number of deaths during a given time interval) / (total population in that interval) x (expressed unit – usually use per 1000 – 100,000 individuals)

Usefulness: It is the last and worst outcome that can occur in health problems. It can indicate the health status of a population and assess the severity of receiving exposure leading to death. It is also useful to public health authorities to prioritize the health issue.

Neonatal mortality rate:

Definition and calculation: It is the number of resident newborns in a specified
geographic area dying at less than 28 days of age divided by the
number of resident live births for the same geographic area (for a specified time period, usually a calendar year) and multiplied by 1,000

Example, 700 neonatal deaths and 150000 live births in a state in 2008 = (700/150,000)*100 = 4.7 neonatal deaths per 1,000 live births in a state in 2008

Usefulness: Estimates the number of newborns dying per live births in a given year and geographic area.

Reference: https://www-doh.state.nj.us/doh-shad/view/sharedstatic/NeonatalMortalityRate.pdf

Case-Fatality rate (CFR)
1. Definition of each vital statistic?
Case Fatality Rate (CFR) indicates the severity of a particular disease by defining the total number of deaths as a proportion of reported cases of a specific disease at a specific time.

2. How to calculate each vital statistic?
CFR is presented as a percentage (0%-100%) or a ratio (between 0-1) and measures the number of confirmed deaths among the number of confirmed diagnosed cases of a particular disease at a given time.

3. What are the main usefulness of each vital statistic?
CFR measures the severity of a particular infectious disease within a particular environment at a specific time.

Maternal Mortality Rate and Maternal Mortality Ratio

Definition

The maternal mortality rate is the number of maternal deaths in a population divided by the number of women of reproductive age. It is usually described together with maternal mortality ratio. But they are not the same.

The maternal mortality ratio (MMR) is defined as the number of maternal deaths during a given time period per 100,000 live births during the same time period.

Calculation

The definitions of both maternal mortality rate and maternal mortality ratio are self-explanatory in terms of calculation.

For maternal mortality rate,
( Number of maternal deaths / Number of women of reproductive age ) X 100,000

For maternal mortality ratio
(Number of maternal deaths / Number of live births) X 100,000

, where maternal deaths account for “female deaths from any cause related to or aggravated by pregnancy or its management (excluding accidental or incidental causes) during pregnancy and childbirth or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy.

But in reality, especially in the developing countries, the actual data are not available due to under-reporting, misclassification and other data quality issues. In such times, they are estimated.

The maternal mortality ratio for Myanmar was 250 deaths per 100,000 live births in 2017 (which is the lowest among countries in Asia/Pacific region). And it was estimated by a regression model using information on fertility, birth attendants, and HIV prevalence. The exact calculation and estimation methods may differ county to country based on the availability of data resources.

Uses

Maternal mortality rate – to reflect not only the risk of maternal death per pregnancy or birth but also the level of fertility in the population

Maternal mortality ratio – to describe the risk of maternal death relative to the number of live births and essentially captures the risk of death in a single pregnancy or a single live birth

They are considered to be primary and important indictors of a country’s overall health status and quality of life. When the health services and facilities are developed, and socio-economic status of the people in the country are high, these indicators tend to be low.

Maternal mortality ratio is one of the indicators in SDG. And it sets out that by 2030, the global maternal mortality ratio (MMR) should be reduced to less than 70 per 100,000 live births, and no country should have an MMR more than 140 per 100,000 live births.

References:
WHO Website
Knomea Website
OECD Website

Age-specific mortality rate

Definition
It is a measure of number of deaths in a particular population of a specific age during a particular time period.

Calculation
The numerator is the number of deaths in a specific age group during a particular time period. The denominator is the number of persons in that population of specific age during that time period.

Usefulness
For example, the crude mortality rate of Alzheimer’s disease might be very low, however, if we narrow down the age group to 60-90, this age-specific mortality rate might be able to reflect more on the severity of Alzheimer’s disease.

specific attack rate (Actually “specific incidence proportion”)

Definition – the incidence proportion (attack rate) in specific, interested population/sample

Calculation – number of cases group by specific attribute / number of population group by specific attribute

Usefulness – specific attack rate give more information about occurrence of disease such as the attack rate of influenza-like illness among students and teachers in the school, is the the different between students and teachers? that could lead to hypothesis generation and testting.

Case-Fatality rate

Definition: Case-Fatality rate is the proportion of people who die from a specified disease among all individuals diagnosed with the disease over a certain period of time.

Calculate: The number of deaths from a specified disease over a defined period of time divided by the number of individuals diagnosed with the disease during that time

Usefulness: Used as a measure of disease severity and used for prognosis (predicting disease course or outcome), where comparatively high rates are indicative of relatively poor outcomes.

AGE-SPECIFIC DEATH RATE
1. Definition:
Age-specific mortality rates is the number of deaths in a particular age group per 1,000 population in the same age group

2. Calculation:
= (Total Deaths in Specified Age Group/Total Population in the Same Specified Age Group)X 1,000

3. Usefulness:
Age-specific mortality rates allow comparison between specified geographic area and over time for specific age groups. Because all-age mortality is not very useful for health planning or monitoring, so we need to know how many deaths occur in different age groups.