Physiological Determinants of Maternal Mortality Risk in Tertiary Hospitals of North East Nigeria: A Multi-Centre Analysis

Maternal mortality in North East Nigeria remains among the highest in the country, and identifying the physiological determinants that predict fatal outcomes can inform targeted clinical interventions. This study examined physiological determinants of maternal mortality risk across three tertiary hospitals in Borno, Adamawa, and Gombe States in North East Nigeria. A retrospective case-control design reviewed 300 delivery records, comprising 100 maternal deaths and 200 age-matched maternal survivors over a three-year period. Physiological variables extracted from records included admission blood pressure, haemoglobin concentration, gestational age, foetal presentation, mode of delivery, and presence of complications including eclampsia, postpartum haemorrhage, and sepsis. Logistic regression and chi-square tests were applied. Results identified eclampsia, severe anaemia, and haemorrhagic shock as the leading physiological predictors of mortality, with odds ratios highest for uncontrolled haemorrhage. Admission haemoglobin below 7 grams per decilitre doubled mortality risk. Blood pressure above 160/110 millimetres of mercury was independently fatal. This study contributes multi-centre evidence on physiological mortality predictors from a high-burden region lacking such systematic analysis. Routine physiological triage scoring in obstetric admissions, blood bank strengthening, and magnesium sulphate availability are recommended as priority life-saving interventions. Keywords: maternal mortality, eclampsia, anaemia, postpartum haemorrhage, North East Nigeria.