Poverty and InequalitySexual and Reproductive HealthFamily, Maternal & Child HealthMethodology

Pregnancy-Related Mortality in the United States, 2011-2013

TitlePregnancy-Related Mortality in the United States, 2011-2013
Publication TypeJournal Article
Year of Publication2017
AuthorsCreanga, AA, Syverson, C, Seed, K, Callaghan, WM
JournalObstet Gynecol
Date PublishedAug
ISBN Number0029-7844
Accession Number28697109
Keywords*Maternal Mortality/ethnology, Abortion, Induced/mortality, Abortion, Spontaneous/mortality, Adolescent, Adult, African Americans, Cause of Death, Ethnic Groups, European Continental Ancestry Group, Female, Hispanic Americans, Humans, Live Birth/epidemiology, Maternal Age, Middle Aged, Pregnancy, Pregnancy Complications, Cardiovascular/mortality, Pregnancy Complications/mortality, Pregnancy Outcome, Pregnancy, Ectopic/epidemiology/mortality, Puerperal Disorders/mortality, Stillbirth/epidemiology, United States/epidemiology, Young Adult

OBJECTIVE: To update national population-level pregnancy-related mortality estimates and examine characteristics and causes of pregnancy-related deaths in the United States during 2011-2013. METHODS: We conducted an observational study using population-based data from the Pregnancy Mortality Surveillance System to calculate pregnancy-related mortality ratios by year, age group, and race-ethnicity groups. We explored 10 cause-of-death categories by pregnancy outcome during 2011-2013 and compared their distribution with those in our earlier reports since 1987. RESULTS: The 2011-2013 pregnancy-related mortality ratio was 17.0 deaths per 100,000 live births. Pregnancy-related mortality ratios increased with maternal age, and racial-ethnic disparities persisted with non-Hispanic black women having a 3.4 times higher mortality ratio than non-Hispanic white women. Among causes of pregnancy-related deaths, the following groups contributed more than 10%: cardiovascular conditions ranked first (15.5%) followed by other medical conditions often reflecting pre-existing illnesses (14.5%), infection (12.7%), hemorrhage (11.4%), and cardiomyopathy (11.0%). Relative to the most recent report of Pregnancy Mortality Surveillance System data for 2006-2010, the distribution of cause-of-death categories did not change considerably. However, compared with serial reports before 2006-2010, the contribution of hemorrhage, hypertensive disorders of pregnancy, and anesthesia complications declined, whereas that of cardiovascular and other medical conditions increased (population-level percentage comparison). CONCLUSION: The pregnancy-related mortality ratio and the distribution of the main causes of pregnancy-related mortality have been relatively stable in recent years.