WEDNESDAY, March 13, 2024 (HealthDay News) — Lower, stable maternal mortality rates are seen on identification of maternal deaths by requiring mention of pregnancy among multiple causes of death, according to a study published online March 12 in the American Journal of Obstetrics & Gynecology.
K.S. Joseph, M.D., Ph.D., from the University of British Columbia in Vancouver, Canada, and colleagues examined maternal deaths in the United States from 1999 to 2021. Deaths were identified due to a positive pregnancy checkbox per National Vital Statistics System methodology or under an alternative formulation as having at least one mention of pregnancy among the multiple causes of death on the death certificate.
The researchers found a 144 percent increase in maternal deaths per National Vital Statistics System methodology from 9.65 to 23.6 per 100,000 live births from 1999-2002 to 2018-2021; increases were seen in all race and ethnicity groups. During the same time period, there was an increase in direct obstetrical deaths from 8.41 to 14.1 per 100,000 live births, while indirect obstetrical deaths increased from 1.24 to 9.41; in 2018 to 2021, 38 and 87 percent of direct and indirect obstetrical deaths, respectively, were identified because of a positive pregnancy checkbox. Using the alternative formulation, the maternal mortality rate was 10.2 and 10.4 per 100,000 live births in 1999 to 2002 and 2018 to 2021, respectively; there was a decrease seen in deaths from direct obstetrical causes from 7.05 to 5.82 per 100,000 live births.
“By not relying on the pregnancy checkbox, our approach avoided the misclassification that has given the false impression of increasing maternal mortality rates in the United States,” coauthor Justin S. Brandt, M.D., from the NYU Grossman School of Medicine in New York City, said in a statement.
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