Understanding Maternal Mortality
What’s All the Buzz About?
Maternal Mortality is an interesting, albeit morose, statistic. In a very general sense, “maternal mortalityâ€, is when a pregnant or recently pregnant woman dies. In some references this is broken down to three subgroups: “Direct Maternal Deathâ€, “Non-Direct Maternal Deathâ€, and “Non-Maternal Maternal Deathâ€. This is to distinguish these differing scenarios:
Direct: A woman dies from postpartum hemorrhage
Indirect: A woman dies during pregnancy of complications of sickle cell disease exacerbated by the pregnancy
Non-Maternal: A pregnant woman (perhaps along with other passengers) dies resultant of a motor vehicle accident. In such an event, it is presumed that the death would have occurred even if the woman were not pregnant. The pregnancy was coincidental.
In 2019, the Centers for Disease Control changed its coding for maternal deaths and now the Pregnancy Mortality Surveillance System tracks this statistic. In current statistics, what have been called “Direct and Indirect†are now referred to as, “Pregnancy-related deaths†(PRD).
This statistic is expressed as a ratio of deaths per 100,000 live births (if it were listed as a percentage, the numeral would be so small that it would be difficult to express verbally.
The CDC reports the PRD rate nationally as 23.5. The three states with the lowest rates are: California (10), Wisconsin (12), and Minnesota (13). The three states with the highest rates are: Arkansas (44), Mississippi (43), and Tennessee (42). We see here that the lower states are roughly half the national rate, and the higher states nearly double.
Causes of PRD:
- “Other†cardiovascular conditions, 14.5%
- Infection or sepsis, 14.3 %
- Cardiomyopathy, 12.1%
- Hemorrhage, 12.1%
- Thrombotic disorder, 10.5%
- Hypertensive disorders of pregnancy, (surprising to me that this is not number 1), 6.3%
Race
This is what all the “buzz†is about. One must wonder if we consider the race differential and the leading causes of PRD, we know where to look most closely at trying to not have this horrid occurrence sneak up on us.
