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Pregnancy-Related Mortality in the United States, 2006–2010

Creanga, Andreea A. MD, PhD; Berg, Cynthia J. MD, MPH; Syverson, Carla CNM, MPH; Seed, Kristi BS; Bruce, F. Carol RN, MPH; Callaghan, William M. MD, MPH

doi: 10.1097/AOG.0000000000000564
Contents: Original Research

OBJECTIVE: To update national population-level pregnancy-related mortality estimates and examine characteristics and causes of pregnancy-related deaths in the United States during 2006–2010.

METHODS: We used data from the Pregnancy Mortality Surveillance System and calculated pregnancy-related mortality ratios by year and age group for four race–ethnicity groups: non-Hispanic white, non-Hispanic black, Hispanic, and other. We examined causes of pregnancy-related deaths by pregnancy outcome during 2006–2010 and compared causes of pregnancy-related deaths since 1987.

RESULTS: The 2006–2010 pregnancy-related mortality ratio was 16.0 deaths per 100,000 live births (20,959,533 total live births). Specific race–ethnicity pregnancy-related mortality ratios were 12.0, 38.9, 11.7, and 14.2 deaths per 100,000 live births for non-Hispanic white, non-Hispanic black, Hispanic, and other race women, respectively. Pregnancy-related mortality ratios increased with maternal age for all women and within all age groups, non-Hispanic black women had the highest risk of dying from pregnancy complications. Over time, the contribution to pregnancy-related deaths of hemorrhage, hypertensive disorders of pregnancy, embolism, and anesthesia complications continued to decline, whereas the contribution of cardiovascular conditions and infection increased. Seven of 10 categories of causes of death each contributed from 9.4% to 14.6% of all 2006–2010 pregnancy-related deaths; cardiovascular conditions ranked first.

CONCLUSION: Relative to previous years, during 2006–2010, the U.S. pregnancy-related mortality ratio increased as did the contribution of cardiovascular conditions and infection to pregnancy-related mortality. Although the identification of pregnancy-related deaths may be improving in the United States, the increasing contribution of chronic diseases to pregnancy-related mortality suggests a change in risk profile of the birthing population.

LEVEL OF EVIDENCE: II

Relative to previous years, during 2006–2010, the U.S. pregnancy-related mortality ratio increased, as did the contribution of cardiovascular conditions and infection to pregnancy-related mortality.

Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia.

Corresponding author: Andreea A. Creanga, MD, PhD, Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, 4770 Buford Highway, NE, Mail Stop K-23, Atlanta GA 30341-3717; e-mail: acreanga@cdc.gov.

Financial Disclosure The authors did not report any potential conflicts of interest.

The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

© 2015 by The American College of Obstetricians and Gynecologists.