Maternal mortality has been defined traditionally as deaths "related
to or aggravated by" pregnancy complications, excluding "accidental or incidental
causes," occurring during pregnancy or within 42 days of termination.1 In other words, maternal deaths are those that would
not have occurred if not for the pregnancy. This definition restricts the
potential causal contribution of pregnancy to women's deaths, because only
causes of death that are biologically related to the pregnancy are counted.
However, some deaths are not biologically, but may be socially, related to
the pregnancy and may not have occurred without pregnancy. To capture more
completely all deaths occurring during or after pregnancy, the term "pregnancy-associated
death," which includes "the death of any woman, from any cause, while she
is pregnant—or within one year of termination of pregnancy," was developed.2 Concurrently, enhanced maternal mortality surveillance
techniques were being developed and tested, leading to previously underestimated
maternal mortality rates being recalculated.3-6
Frye V. Examining Homicide's Contribution to Pregnancy-Associated Deaths. JAMA. 2001;285(11):1510–1511. doi:10.1001/jama.285.11.1510
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