Government Agency Navigation

Pregnancy-Related Mortality

Narrative

A pregnancy-related death is defined as a death which occurs during or within one year after the end of a pregnancy, from any cause related to or aggravated by the pregnancy or its management, but not from accidental or incidental causes such as injury.1 This definition includes more deaths than the traditional definition of maternal mortality, which counts pregnancy-related deaths only up to 42 days after the end of pregnancy. Although maternal mortality in the United States declined dramatically over the last century, this trend has reversed somewhat in the last several decades, and racial and ethnic disparities in both maternal and pregnancy-related mortality persist.2,3,4

In 2006-2007, the latest years for which data are available, a total of 1,294 deaths were found to be pregnancy-related (15.1 deaths per 100,000 live births). This represents a substantial increase from 1987 levels of 7.2 pregnancy-related deaths per 100,000 live births.4 However, the extent to which this increase may reflect improved identification and coding of pregnancy-related deaths is unclear.3 The pregnancy-related mortality ratio among Black women was approximately 3.2 times the rate for White women in 2006-2007 (34.8 versus 11.0 per 100,000), a disparity that has remained relatively constant. The pregnancy-related mortality ratio also increased with age. Women aged 35-39 years were more than twice as likely to die from pregnancy-related causes as women aged 20-24; for women older than 39 years, the risk increased five-fold (data not shown in graph images or in data tables on this site).3

Some of the most common causes of pregnancy- related death in 2006-2007 were cardiovascular disease (13.5%), diseases of the heart muscle (cardiomyopathy, 12.6%), uncontrolled bleeding (hemorrhage, 11.9%), and non-cardiovascular medical conditions (11.8%). In 1987-1990, hemorrhage was the leading cause of pregnancy-related deaths (29%); hypertensive disorders of pregnancy, including preeclampsia and eclampsia, accounted for almost 18 percent of pregnancy-related deaths, compared to 11.1 percent in 2006-2007.2,4

1 Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Pregnancy Mortality Surveillance System. Pregnancy-Related Mortality in the U.S. Accessed March 2, 2012.

2 Singh GK. Maternal Mortality in the United States, 1935-2007. Rockville, MD: US Department of Health and Human Services; 2010

3 Berg CJ, Callaghan WM, Syverson C, Henderson Z. Pregnancy-related mortality in the United States, 1998- 2005. Obstet Gynecol. 2010;116:1302-1309

4 Koonin LM, MacKay AP, Berg CJ, Atrash HK, Smith JC. Pregnancy-related mortality surveillance -- United States, 1987-1990. CDC surveillance summaries (Aug 1997). MMWR 1997;46(No. SS-4):17-36

Graphs

This image is described in the Data section.

maternal mortality rates graph

This image is described in the Data section.

leading causes of maternal mortality graph

Data

Pregnancy-Related Mortality Ratios, by Race, 2006–2007
Race Deaths per 100,000 Live Births
Source: Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Pregnancy Mortality Surveillance System. Pregnancy-Related Mortality in the U.S. Accessed 03/02/2012.
Total 15.1
White 11
Black 34.8
Other 15.7
Leading Causes of Pregnancy-Related Deaths,* 2006–2007
Cause of Pregnancy-Related Death Percent of Pregnancy-Related Deaths
*The cause of death was unknown for 5.6% of all pregnancy-related deaths.
Source: Centers for Disease Control and Prevention, Division of Reproductive Health, Pregnancy Mortality Surveillance System. Pregnancy-Related Mortality in the U.S. Accessed 03/02/2012.
Cardiovascular Disease 13.5
Cardiomyopathy (Heart Muscle Diseases) 12.6
Hemorrhage (Uncontrolled Bleeding) 11.9
Non-Cardiovascular Diseases 11.8
Hypertensive Disorders of Pregnancy 11.1
Infection/Sepsis 11.1
Thrombotic Pulmonary Embolism (Blood Clot in Lung) 10.9
Amniotic Fluid Embolism 5.6
Cerebrovascular Accidents (Stroke) 5.3
Anesthesia Complications 0.6