US Pregnancy-Related Deaths Rise 28% Over 5 Years

TOPLINE:

The United States reported the highest pregnancy-related death rate among high-income countries, with 6283 deaths documented from 2018 to 2022. American Indian and Alaska Native women faced the highest mortality rate at 106.3 deaths per 100,000 live births, followed by non-Hispanic Black women at 76.9 deaths per 100,000 live births.

METHODOLOGY:

Researchers conducted a serial cross-sectional study using nationwide data from the Centers for Disease Control and Prevention’s Wide-Ranging Online Data for Epidemiologic Research.
Analysis included all pregnancy-related deaths among women aged 15-54 years from 2018 to 2022, with state, race and ethnicity, and age as exposure variables.
A total of 18,475,989 live births among women aged 15-54 years in the United States were identified during the study period.
Primary outcomes encompassed all-cause and cause-specific maternal death and late maternal death, defined as deaths occurring more than 42 days and up to 1 year after pregnancy.

TAKEAWAY:

During 2018-2022, researchers documented 6283 pregnancy-related deaths, including 1891 late maternal deaths, with age-standardized rate increasing by 27.7% from 25.3 deaths per 100,000 live births (95% CI, 23.7-26.9) in 2018 to 32.6 deaths per 100,000 live births (95% CI, 31.2-34.8) in 2022.
State-specific mortality rates varied considerably, ranging from 18.5 to 59.7 deaths per 100,000 live births.
American Indian and Alaska Native women experienced highest age-standardized annual and aggregated rate at 106.3 deaths per 100,000 live births (95% CI, 103.1-109.6), followed by non-Hispanic Black women at 76.9 deaths per 100,000 live births (95% CI, 74.2-79.7).

IN PRACTICE:

“If the nation had achieved the lowest state rate estimated here, 2679 pregnancy-related deaths could have been prevented during the study period. Additionally, the pregnancy-related death rate was 3.8 times higher among American Indian and Alaska Native women and 2.8 times higher among non-Hispanic Black women compared with the rate among non-Hispanic White women. Although cardiovascular disease was the leading cause of the overall pregnancy-related death, cancer, drug-induced and alcohol-induced death, and mental and behavior disorders are important contributing causes of late maternal death,” wrote the authors.

SOURCE:

The study was led by Yingxi Chen, MD, PhD, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health in Rockville, Maryland. It was published online on April 9 in JAMA Network Open.

LIMITATIONS:

Researchers noted concerns about the quality of data on pregnancy-related death, including the effects of introducing the pregnancy checkbox to death certificates and potential misclassification of pregnancy status. Death certificate data may misclassify race and ethnicity as such information is not self-reported. Due to data availability constraints, researchers could only assess diseases associated with late maternal deaths, while actual causes at the national level were difficult to measure. Small numbers in some subgroups and data availability limitations prevented age-standardized estimates for states and rates for certain racial and ethnic groups.

DISCLOSURES:

The study received funding from the National Cancer Institute Intramural Research Program. The funder had no role in the study design, data collection, analysis, interpretation, manuscript preparation, or publication decisions.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.