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Child Health USA 2013 An illustrated collection of current and historical data, published annually.

Pregnancy-Related Mortality

Narrative

A pregnancy-related death is defined as a death which occurs during or within one year of 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, there has been some reversal of this trend in the last several decades, and racial and ethnic disparities in maternal and pregnancy-related mortality persist.2,3,4

In 2006–2009, the latest years for which data are available, a total of 2,689 deaths were found to be pregnancy-related at a rate of 15.8 deaths per 100,000 live births. The pregnancy-related mortality rate has more than doubled from 1987 levels of 7.2 deaths per 100,000.5 This dramatic rise may reflect improved ascertainment of pregnancy-related deaths as well as increases in chronic conditions and severe maternal morbidity. 6,7 The pregnancy-related mortality ratio among Black women was 3 times the rate for White women in 2006-2008 (35.6 versus 11.7 per 100,000), a disparity that has remained relatively constant. The pregnancy-related mortality ratio also increases with age. Women aged 35–39 years are more than twice as likely to die from pregnancy-related causes as women aged 20–24; for women older than 39 years, the risk increases five-fold (data not shown in graph images or in data tables on this site).8

Some of the most common causes of pregnancy- related death in 2006–2009 were cardiovascular disease (14.6%), infection or sepsis (14.0%), non-cardiovascular medical conditions (11.9%) diseases of the heart muscle (cardiomyopathy, 11.8%), and uncontrolled bleeding (hemorrhage, 11.0%). The proportion of pregnancy-related deaths due to cardiovascular disease and cardiomyopathy have increased significantly since 1987, while the percentage of deaths attributable to hemorrhage and hypertensive disorders of pregnancy have declined.9

1 Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Pregnancy Mortality Surveillance System. Pregnancy Mortality Surveillance System. Accessed: 04/23/2013.

2 Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Pregnancy Mortality Surveillance System. Pregnancy Mortality Surveillance System. Accessed: 04/23/2013.

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

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

5 Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Pregnancy Mortality Surveillance System. Pregnancy Mortality Surveillance System. Accessed: 04/23/2013.

6 Callaghan WM, Creanga AA, Kuklina EV. Severe maternal morbidity among delivery and postpartum hospitalizations in the United States. Obstet Gynecol. 2012 Nov;120(5):1029-36.

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

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

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

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Graphs

This image is described in the Data section.

pregnancy-related ratios by race graph

This image is described in the Data section.

leading causes of pregnancy-related deaths graph

Data

Pregnancy-Related Mortality Ratios, by Race, 2006-2009

Deaths per 100,000 Live Births:

  • White 11.7
  • Black 35.6
  • Other 17.6
  • Total 15.8

Source: Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Pregnancy Mortality Surveillance System. Pregnancy Mortality Surveillance System. Accessed: 04/23/2013.

Leading Causes of Pregnancy-Related Deaths, 2006–2009

Percent of Pregnancy-Related Deaths:*

  • Cardiovascular Disease 14.6
  • Infection/Sepsis 14.0
  • Non-Cardiovascular Diseases 11.9
  • Cardiomyopathy (Heart Muscle Diseases) 11.8
  • Hemorrhage (Uncontrolled Bleeding) 11.0
  • Hypertensive Disorders of Pregnancy 9.9
  • Thrombotic Pulmonary Embolism (Blood Clot in Lung) 9.4
  • Cerebrovascular Accidents (Stroke) 6.1
  • Amniotic Fluid Embolism 5.4
  • Anesthesia Complications 0.6

*The cause of death was unknown for 5.3% of all pregnancy-related deaths.

Source: Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Pregnancy Mortality Surveillance System. Pregnancy Mortality Surveillance System. Accessed: 04/23/2013.