Factors that increase maternal death can be direct or indirect. In a 2009 article on maternal morbidity, the authors said that, generally, there is a distinction between a direct maternal death that is the result of a complication of the pregnancy, delivery, or management of the two, and an indirect maternal death, that is a pregnancy-related death in a patient with a preexisting or newly developed health problem unrelated to pregnancy. Fatalities during but unrelated to a pregnancy are termed "accidental", "incidental", or non-obstetrical maternal deaths.