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News From the Centers for Disease Control and Prevention
October 22/29, 2019

Disparities in Maternal Mortality

JAMA. 2019;322(16):1545. doi:10.1001/jama.2019.16156

Black and American Indian/Alaskan Native mothers in the United States were 2 to 3 times more likely to die from pregnancy-related causes between 2007 and 2016, according to a recent CDC report. Overall, pregnancy-related mortality in the United States rose from 15 to 17 per 100 000 live births during this period, while global rates have been decreasing.

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Data for 2007 through 2016 from the CDC’s Pregnancy Mortality Surveillance System found that the rate of pregnancy-related deaths per 100 000 live births was 40.8 for black mothers and 29.7 for American Indian/Alaskan Native mothers compared with 12.7 for white mothers. These disparities worsened with maternal age; pregnancy-related death rates for black and American Indian/Alaskan Native mothers aged 30 years or older were about 4 to 5 times higher than their white counterparts. Higher education levels did not erase these disparities. In fact, pregnancy-related death rates for black and American Indian/Alaskan Native women with at least some college education were higher than those rates for mothers with less than a high school diploma for all other racial and ethnic groups, the authors wrote.

Compared with white mothers, black mothers experienced disproportionately high rates of death from cardiomyopathy, thrombotic pulmonary embolism, and hypertensive disorders of pregnancy, while American Indian/Alaskan Native mothers experienced disproportionately high rates of death from hemorrhage and hypertensive disorders. This is despite previous findings that suggest 60% of pregnancy-related deaths are preventable regardless of race or ethnicity.

“There is an urgent need to identify and evaluate the complex factors contributing to these disparities and to design interventions that will reduce preventable pregnancy-related deaths,” said lead author Emily Petersen, MD, medical officer at the CDC’s Division of Reproductive Health in a statement.

To that end, the authors suggested that hospitals implement standardized quality improvement protocols and work to identify and eliminate implicit bias to improve patient-clinician interactions and patient outcomes.

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