Why African-American women are at greater risk for pregnancy-related death

Ann Epidemiol. 2007 Mar;17(3):180-5. doi: 10.1016/j.annepidem.2006.10.004.


Purpose: Our study aim was to identify factors that may contribute to the racial disparity in pregnancy-related mortality.

Methods: We examined differences in severity of disease, comorbidities, and receipt of care among 608 (304 African-American and 304 white) consecutive patients of non-Hispanic ethnicity with one of three pregnancy-related morbidities (pregnancy-related hypertension, puerperal infection, and hemorrhage) from hospitals selected at random from a statewide region.

Results: African-American women had more severe hypertension, lower hemoglobin concentrations preceding hemorrhage, more antepartum hospital admissions, and a higher rate of obesity. The rate of surgical intervention for hemorrhage was lower among African-Americans, although the severity of hemorrhage did not differ between the two racial groups. More African-American women received eclampsia prophylaxis. After stratifying by severity of hypertension, we found that more African-Americans received antihypertensive therapy. The rate of enrollment for prenatal care was lower in the African-American group. Among women receiving prenatal care, African-American women enrolled significantly later in their pregnancies.

Conclusions: We have identified racial differences in severity of disease, comorbidities, and care status among women with pregnancy-related complications that would place African-Americans at disadvantage to survive pregnancy. These differences are potentially modifiable.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • African Americans / statistics & numerical data*
  • Comorbidity
  • Female
  • Health Behavior
  • Health Status*
  • Humans
  • Maternal Mortality*
  • Pregnancy
  • Pregnancy Complications / ethnology*
  • Pregnancy Complications / mortality*
  • Prenatal Care / statistics & numerical data