Trends and Determinants of Maternal Mortality: A Seven-year Retrospective Analysis from a Tertiary Care Hospital in Kashmir, India

Introduction: Maternal mortality remains a critical indicator of healthcare quality and access, particularly in low- and middleincome settings. Despite progress in India, regional disparities persist, with the union territory of Jammu and Kashmir facing unique challenges in timely obstetric care. Aim: To analyse the trends, causes, and demographic distribution of maternal deaths over seven years at a Tertiary Maternity Hospital in Kashmir, India. Materials and Methods: The present retrospective analysis was conducted at LD Hospital, Srinagar, Kashmir, India, including all maternal deaths from April 2018 to March 2025. Data on age, referral status, residence, and cause of death were extracted from hospital records and analysed using descriptive statistics. Results: Among 151,870 live births, 173 maternal deaths occurred, yielding an overall Maternal Mortality Ratio (MMR) of 114 per 100,000 live births. MMR peaked at 141 in 2021-22 during COVID-19 disruptions and declined to 71 in 2024-25. The mean age of deaths was 29.7 years, and approximately 70% were referrals. Conclusion: Although maternal mortality declined after 2022, preventable causes remain predominant. Strengthening referral systems and timely emergency obstetric care are essential to further reduce maternal deaths.