Pregnancy-Related Mortality in the United States, 2011-2013

Obstet Gynecol. 2017 Aug;130(2):366-373. doi: 10.1097/AOG.0000000000002114.

Abstract

Objective: To update national population-level pregnancy-related mortality estimates and examine characteristics and causes of pregnancy-related deaths in the United States during 2011-2013.

Methods: We conducted an observational study using population-based data from the Pregnancy Mortality Surveillance System to calculate pregnancy-related mortality ratios by year, age group, and race-ethnicity groups. We explored 10 cause-of-death categories by pregnancy outcome during 2011-2013 and compared their distribution with those in our earlier reports since 1987.

Results: The 2011-2013 pregnancy-related mortality ratio was 17.0 deaths per 100,000 live births. Pregnancy-related mortality ratios increased with maternal age, and racial-ethnic disparities persisted with non-Hispanic black women having a 3.4 times higher mortality ratio than non-Hispanic white women. Among causes of pregnancy-related deaths, the following groups contributed more than 10%: cardiovascular conditions ranked first (15.5%) followed by other medical conditions often reflecting pre-existing illnesses (14.5%), infection (12.7%), hemorrhage (11.4%), and cardiomyopathy (11.0%). Relative to the most recent report of Pregnancy Mortality Surveillance System data for 2006-2010, the distribution of cause-of-death categories did not change considerably. However, compared with serial reports before 2006-2010, the contribution of hemorrhage, hypertensive disorders of pregnancy, and anesthesia complications declined, whereas that of cardiovascular and other medical conditions increased (population-level percentage comparison).

Conclusion: The pregnancy-related mortality ratio and the distribution of the main causes of pregnancy-related mortality have been relatively stable in recent years.

MeSH terms

  • Abortion, Induced / mortality
  • Abortion, Spontaneous / mortality
  • Adolescent
  • Adult
  • African Americans
  • Cause of Death
  • Ethnic Groups
  • European Continental Ancestry Group
  • Female
  • Hispanic Americans
  • Humans
  • Live Birth / epidemiology
  • Maternal Age
  • Maternal Mortality* / ethnology
  • Middle Aged
  • Pregnancy
  • Pregnancy Complications / mortality
  • Pregnancy Complications, Cardiovascular / mortality
  • Pregnancy Outcome
  • Pregnancy, Ectopic / epidemiology
  • Pregnancy, Ectopic / mortality
  • Puerperal Disorders / mortality
  • Stillbirth / epidemiology
  • United States / epidemiology
  • Young Adult