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News From the Centers for Disease Control and Prevention
June 25, 2019

Preventing Maternal Deaths

JAMA. 2019;321(24):2397. doi:10.1001/jama.2019.7438

Three in 5 pregnancy-related deaths in the United States from 2011 through 2015 were preventable, according to a CDC report. The report notes that 31% of such maternal deaths occur during pregnancy, about 36% happen during delivery or in the week after, and about 33% occur between a week and a year after deliver.

The CDC’s Pregnancy Mortality Surveillance System recorded 3410 pregnancy-related deaths between 2011 and 2015—roughly 700 deaths per year or 17.2 maternal deaths per 100 000 live births. Cardiovascular events accounted for about one-third of maternal deaths for which the timing of death was known (2990). Depending on the condition, the timing of death varied. Approximately 60% of hypertension-related deaths occurred within a week of delivery while over half of stroke-related deaths occurred 1 to 42 days after delivery. Cardiomyopathy deaths occurred most frequently 43 days to 1 year after delivery. Severe bleeding, hypertensive disorders, and infection were the leading causes of death 1 to 6 days postpartum.

These latest data add to growing concerns about worsening maternal mortality rates in the United States, particularly among women of color. Black women and American Indian/Alaska Native women experienced disproportionately high rates of maternal death (42.8 per 100 000 and 32.5 per 100 000, respectively) compared with white women (13.0 per 100 000), according to the report.

“The bottom line is that too many women are dying largely from preventable deaths associated with their pregnancies,” said Ann Schuchat, MD, principle deputy director of the CDC. “We have the means to close gaps in the care they receive.”

Schuchat emphasized that hospitals can improve care by preparing for obstetric emergencies and that primary care providers can help by ensuring women get good prenatal care and by managing chronic conditions. Efforts to reduce structural racism that may limit women’s access to quality prenatal and postnatal care also are needed, noted Rear Admiral Wanda Barfield, MD, MPH, director of CDC’s Division of Reproductive Health.