The CDC’s Morbidity and Mortality Weekly Report dated May 10, 2019 entitled “Vital Signs: Pregnancy-Related Deaths, United States, 2011–2015, and Strategies for Prevention, 13 States, 2013–2017” concluded that “Approximately three in five pregnancy-related deaths were preventable.” Approximately 700 women die annually in the United States from pregnancy-related complications.
The CDC analyzed data from its national Pregnancy Mortality Surveillance System (PMSS) for 2011–2015. The pregnancy-related mortality ratio (PRMR) is the number of pregnancy-related deaths per 100,000 live births. PRMRs were calculated by race/ethnicity, age, marital status, education, and year. Among pregnancy-related deaths for which timing was known, 31.3% deaths occurred during pregnancy, 16.9% on the day of delivery, 18.6% on days 1–6 postpartum, 21.4% on days 7–42 postpartum, and 11.7% on days 43–365 postpartum. Acute obstetric emergencies such as hemorrhage and amniotic fluid embolism most commonly occurred on the day of delivery, whereas deaths caused by hypertensive disorders of pregnancy and thrombotic pulmonary embolism most commonly occurred 0–6 days postpartum, and during pregnancy and 1–42 days postpartum, respectively. Cardiomyopathy was the most common cause of death in the late postpartum period (43–365 days postpartum).
During 2011–2015, a total of 3,410 pregnancy-related deaths occurred in the United States; the overall PRMR was 17.2 pregnancy-related deaths per 100,000 live births. The highest PRMRs were in women who were black (42.8) and American Indian/Alaska Native (32.5); these PRMRs were 3.3 and 2.5 times as high, respectively, as were those in white women (13.0). The higher proportion of pregnancy-related deaths in the late postpartum period among black women is likely attributable to higher proportion of pregnancy-related deaths due to cardiomyopathy among these women.
The PRMR was highest among women aged ≥35 years and women who were not married. The overall PRMR fluctuated by year, ranging from 15.9 (2012) to 18.0 (2014).
Leading causes of death included cardiovascular conditions, infection, and hemorrhage, and varied by timing. When combined, cardiovascular conditions were responsible for >33% of pregnancy-related deaths; these conditions include cardiomyopathy (10.8%), other cardiovascular conditions (15.1%), and cerebrovascular accidents (7.6%). Other leading causes of pregnancy-related death included other noncardiovascular medical conditions (14.3%), infection (12.5%), and obstetric hemorrhage (11.2%). The cause of death could not be determined for 6.7% of pregnancy-related deaths.
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. Among 251 pregnancy-related deaths evaluated for preventability by the 13 MMRCs, a determination was made for 232 (92.4%). Among these, 139 (60.0%) were determined to be preventable deaths.
If you or your baby suffered a birth injury (or worse) during labor and/or delivery in the United States, you should promptly find a birth injury lawyer in your state who may investigate your birth injury claim for you and represent you and your child in a birth injury medical malpractice case, if appropriate. If a death occurred during pregnancy or shortly thereafter that may be due to medical negligence, we may be able to find you a local medical malpractice lawyer in your state who may represent you in a medical malpractice wrongful death claim.
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