The Black-White disparity in pregnancy-related mortality from 5 conditions: differences in prevalence and case-fatality rates

Am J Public Health. 2007 Feb;97(2):247-51. doi: 10.2105/AJPH.2005.072975. Epub 2006 Dec 28.

Abstract

Objectives: We sought to determine whether differences in the prevalences of 5 specific pregnancy complications or differences in case fatality rates for those complications explained the disproportionate risk of pregnancy-related mortality for Black women compared with White women in the United States.

Methods: We used national data sets to calculate prevalence and case-fatality rates among Black and White women for preeclampsia, eclampsia, abruptio placentae, placenta previa, and postpartum hemorrhage for the years 1988 to 1999.

Results: Black women did not have significantly greater prevalence rates than White women. However, Black women with these conditions were 2 to 3 times more likely to die from them than were White women.

Conclusions: Higher pregnancy-related mortality among Black women from preeclampsia, eclampsia, abruptio placentae, placenta previa, and postpartum hemorrhage is largely attributable to higher case-fatality rates. Reductions in case-fatality rates may be made by defining more precisely the mechanisms that affect complication severity and risk of death, including complex interactions of biology and health services, and then applying this knowledge in designing interventions that improve pregnancy-related outcomes.

Publication types

  • Comparative Study

MeSH terms

  • African Americans / statistics & numerical data*
  • European Continental Ancestry Group / statistics & numerical data*
  • Female
  • Health Surveys
  • Hospital Mortality
  • Humans
  • Maternal Mortality / trends*
  • National Center for Health Statistics, U.S.
  • Obstetric Labor Complications / ethnology*
  • Obstetric Labor Complications / mortality*
  • Pregnancy
  • Prevalence
  • Risk Assessment
  • Risk Factors
  • United States / epidemiology