Majority of pregnancy-related deaths are preventable, CDC says

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Dive Brief:

  • More than 80% of maternal deaths across 36 states could have been prevented, according to the Centers for Disease Control and Prevention in a review of pregnancy-related mortality.
  • The data, from multidisciplinary state and local maternal mortality review committees supported by the CDC, showed that 22% of deaths occurred during pregnancy, 25% happened within the first seven days after delivery, and 53% occurred within a year of delivery. Mental health conditions were the No. 1 cause of pregnancy-related mortality linked to 23% of deaths, including suicide and overdose or poisoning related to substance use disorder. 
  • Other leading causes of pregnancy-related death were excessive bleeding (14%), cardiac and coronary conditions (13%), infection (9%), thrombotic embolism (9%), cardiomyopathy (9%) and hypertensive disorders (7%). Information on cause of death can be used to prioritize interventions to save lives and reduce health disparities, the CDC said.

Dive Insight:

The CDC report comes as doctors in dozens of states navigate abortion restrictions in the wake of the Supreme Court ruling overturning Roe v. Wade.

Physicians who testified at a House oversight committee hearing in July described a state of confusion over the determination of exceptions in life-threatening situations, and some experts warned of the potential for worsening maternal mortality rates. 

The maternal mortality rate rose to 23.8 deaths per 100,000 live births in 2020, from 20.1 in 2019, according to the most recent CDC figures.

The CMS is also looking to track pregnancy-related mortality, adding a maternal morbidity measurement to its quality reporting program in the final inpatient payment rule released last month. Hospitals must report whether they participate in efforts to improve perinatal health, including safety practices.

The new CDC report, containing data on 1,018 pregnancy-related deaths from 2017 to 2019, showed the top underlying causes of maternal mortality varied by race and ethnicity. Cardiac and coronary conditions were the primary 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 cause for non-Hispanic Asian people.

The report highlights “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,” Wanda Barfield, director of the CDC’s division of reproductive health at the National Center for Chronic Disease Prevention and Health Promotion, said in a release.

The CDC’s maternal mortality review committees are composed of representatives from diverse clinical and non-clinical backgrounds who review the circumstances around pregnancy-related deaths to identify recommendations for actions to prevent future deaths.

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