More than 80% of pregnancy-related deaths in the US were preventable, according to 2017-2019 data from the Maternal Mortality Review Committees (MMRCs).
The Committee are representatives of diverse clinical and non-clinical backgrounds who review the circumstances around pregnancy-related deaths to identify recommendations to prevent future deaths.
Information from MMRCs in 36 US states on leading causes of death by race and ethnicity can be used to prioritize interventions that can save lives and reduce health disparities.
Quality improvement
“The report paints a much clearer picture of pregnancy-related deaths in this country,” said Wanda Barfield, director of Centre for Disease Control’s Division of Reproductive Health at the National Center for Chronic Disease Prevention and Health Promotion.
“The majority of pregnancy-related deaths were preventable, highlighting the need for quality improvement initiatives in states, hospitals, and communities that ensure all people who are pregnant or postpartum get the right care at the right time.”
Key findings
Among pregnancy-related deaths with information on timing, 22% of deaths occurred during pregnancy, 25% occurred on the day of delivery or within seven days after, and 53% occurred between seven days to one year after pregnancy.
The leading underlying causes of pregnancy-related death include:
- Mental health conditions, including deaths to suicide and overdose/poisoning related to substance use disorder) (23%)
- Hemorrhage (14%)
- Cardiac and coronary conditions relating to the heart (13%)
- Infection (9%)
- Blood clot (9%)
- Cardiomyopathy (9%)
- Hypertensive disorders of pregnancy (7%)
Racial disparity
The leading underlying cause of death varied by race and ethnicity.
Cardiac and coronary conditions were the leading underlying cause of pregnancy-related deaths among non-Hispanic Black people, mental health conditions were the leading underlying cause for Hispanic and non-Hispanic White people, and hemorrhage was the leading underlying cause for non-Hispanic Asian people.
Everyone can help prevent pregnancy-related deaths
More than half (53%) of pregnancy-related deaths happen up to one year after delivery.
It is critical for all healthcare professionals to ask whether their patient is pregnant or has been pregnant in the last year to inform diagnosis and treatment decisions.
Healthcare systems, communities, families, and other support systems need to be aware of the serious pregnancy-related complications that can happen during and after pregnancy.
Prevention recommendations
Examples of prevention recommendations from MMRCs include wider access to insurance coverage to improve prenatal care initiation and follow-up after pregnancy, providing opportunities to prevent barriers to transportation to care, and the need for systems of referral and coordination.
This is the first information to be released under the Enhancing Reviews and Surveillance to Eliminate Maternal Mortality, a CDC-funded program to support agencies and organizations that manage MMRCs.
Recently, CDC significantly expanded its investment in efforts to eliminate preventable pregnancy-related deaths, with new awards totaling $2.8 million to support additional MMRCs in nine jurisdictions.