Comparison of family reporting of pregnancy status with a post-mortem beta-HCG test in deceased women: a study in Pointe-Noire, Congo.

OBJECTIVE: To compare family reports of pregnancy status in deceased women with a biological assessment of pregnancy using a post-mortem beta-HCG test. METHOD: We investigated the deaths of females of reproductive age registered at the Pointe Noire morgue from June 30 to October 18, 2001. A physician interviewed relatives about the circumstances of death, in particular whether the woman had been pregnant at the time of death, and whether she had delivered or had an abortion (induced or spontaneous) within the past 6 weeks. The bodies were then examined and blood samples taken for beta-HCG testing. RESULTS: Among 368 deaths of women of reproductive age registered, 34 deaths were identified as pregnancy-related: 23 by both the family interview and the beta-HCG test, five by beta-HCG test only and six were beta-HCG negative but the family had reported a recent delivery. CONCLUSION: In this setting, the approach based on family reports underestimates mortality during pregnancy by 24% and mortality during pregnancy or within 6 weeks postpartum by 15%.