Background
Approximately 700 women die from pregnancy-related complications in the
United States every year.
Methods
Data from CDC’s national Pregnancy Mortality Surveillance System
(PMSS) for 2011–2015 were analyzed. Pregnancy-related mortality
ratios (pregnancy-related deaths per 100,000 live births; PRMRs) were
calculated overall and by sociodemographic characteristics. The distribution
of pregnancy-related deaths by timing relative to the end of pregnancy and
leading causes of death were calculated. Detailed data on pregnancy-related
deaths during 2013–2017 from 13 state maternal mortality review
committees (MMRCs) were analyzed for preventability, factors that
contributed to pregnancy-related deaths, and MMRC-identified prevention
strategies to address contributing factors.
Results
For 2011–2015, the national PRMR was 17.2 per 100,000 live births.
Non-Hispanic black (black) women and American Indian/Alaska Native women had
the highest PRMRs (42.8 and 32.5, respectively), 3.3 and 2.5 times as high,
respectively, as the PRMR for non-Hispanic white (white) women (13.0).
Timing of death was known for 87.7% (2,990) of pregnancy-related deaths.
Among these deaths, 31.3% occurred during pregnancy, 16.9% on the day of
delivery, 18.6% 1–6 days postpartum, 21.4% 7–42 days
postpartum, and 11.7% 43–365 days postpartum. Leading causes of death
included cardiovascular conditions, infection, and hemorrhage, and varied by
timing. Approximately sixty percent of pregnancy-related deaths from state
MMRCs were determined to be preventable and did not differ significantly by
race/ethnicity or timing of death. MMRC data indicated that multiple factors
contributed to pregnancy-related deaths. Contributing factors and prevention
strategies can be categorized at the community, health facility, patient,
provider, and system levels and include improving access to, and
coordination and delivery of, quality care.
Conclusions
Pregnancy-related deaths occurred during pregnancy, around the time of
delivery, and up to 1 year postpartum; leading causes varied by timing of
death. Approximately three in five pregnancy-related deaths were
preventable.
Implications for Public Health Practice
Strategies to address contributing factors to pregnancy-related deaths can be
enacted at the community, health facility, patient, provider, and system
levels.
