Background: Identifying and controlling medical and social risk factors contributing maternal mortality leads to minimize the rate of mortality particularly in developing nations. The present study aimed to determine risk factors associated with maternal death by focusing the autopsies on cadavers. Methods: In this retrospective study, the hospital recorded files related to 122 pregnant women aged 15 to 45 years who died because of perinatal death that referred to Legal Medical Center between April 2009 and April 2014 were reviewed. All specimens extracted by autopsy had been sent to pathology and toxicology laboratories for further diagnostic assessments. Results: Based on determining the cause of death in forensic medicine center or in hospital, the main causes for death because of clinical reasons (n = 115) was eclampsia in 17.2%and 10.4%, DIC in 14.9% and 8.7%, and uterine atony in 12.1% and 7%, respectively. In hospitals, the causes of death remained unclear in 25.9% that the diagnoses were finalized in legal medicine center as eclampsia, amniotic fluid emboli, cardiovascular and valvular disorders and malignancies. In total, 115 pregnant women died because of clinical causes and 7 of non-clinical causes including choking, hanging, drug overdose, poisoning with Co gas, suicide and car accident. Multivariable logistic regression analyses for determining the main determinants of maternal death could show that in both subgroups with in and out of hospital death, lower number of gravity was only predictor for maternal death. Conclusion: The main causes for maternal death are potentially affected by different geographical, clinical, social, and cultural factors leading introduction of a wide risk variants. As shown in our survey, prim gravity was shown to be the main determinant for maternal death.
