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Complete Indicator Report of Maternal Mortality

Definition

Maternal mortality for the state of Utah is defined as the number of women who have died within 12 months of completion of a pregnancy whose cause of death is due to pregnancy or pregnancy-related causes per 100,000 live births.

Numerator

Number of women of childbearing age who died within 12 months of completion of a pregnancy due to pregnancy or pregnancy-related causes.

Denominator

Number of live births.

Data Interpretation Issues

The Maternal and Infant Health Program of the Utah Department of Health (UDOH) uses the ACOG/CDC Maternal Mortality Study Group definition for maternal mortality and expands the review of deaths to one year after the termination of pregnancy. This definition differs from definitions used by the World Health Organization (WHO), the Centers for Disease Control/National Center for Health Statistics (CDC/NCHS) and UDOH Vital Records, and must be kept in mind when comparing rates. Pregnancy-related cause is defined as a death that resulted from complications of the pregnancy, a chain of events that was initiated by the pregnancy, or the aggravation of an unrelated condition by the physiologic effects of the pregnancy or its management.

Why Is This Important?

Each year in the United States, one woman dies from a pregnancy complication for every 10,000 births. Every death prevented is meaningful. Surveillance of maternal mortality identifies ways to improve the health, health behaviors, and health care of women before and during pregnancy. Surveillance also identifies gaps in the health care system and social services, health care access, and the quality of prenatal and postnatal care.

Healthy People Objective MICH-5:

Reduce the rate of maternal mortality
U.S. Target: 11.4 maternal deaths per 100,000 live births
State Target: 11.4 maternal deaths per 100,000 live births

How Are We Doing?

Utah's maternal mortality has decreased from 36 deaths per year in 1940 to a range of 2-11 deaths per year between 1999 and 2012. Utah's rate of maternal mortality in 2012 was 11.7.

How Do We Compare With U.S.?

Utah's maternal mortality rate, although it has larger fluctuations, is trending along with the U.S. rate (see graph).

The U.S. maternal mortality rate has doubled in the past twenty years. Some of the increase is related to improved data collection, but whether the actual risk of a woman dying from a pregnancy-related condition has increased is unclear. Some of the increase is believed to be associated with the increasing number of Cesarean deliveries, now one-third of all births in the United States. There is now greater maternal mortality associated with heart disease and heart conditions than in previous years. Other chronic conditions such as hypertension and diabetes may put a pregnant woman at higher risk of poor outcomes, and many studies show that an increasing number of women in the U.S. have these conditions.

The higher U.S. pregnancy-related maternal mortality in 2009 is related to the H1N1 influenza pandemic.

What Is Being Done?

Activities conducted by the Division of Family Health and Preparedness include, among others, ongoing maternal and infant mortality surveillance through the Perinatal Mortality Review Program. The Division offers public education about the importance of planning for pregnancy, preconception and interconception health, and recognition and treatment of maternal depression. Members of the Perinatal Mortality Review Committee have participated in a CDC-sponsored Maternal Mortality Initiative this past year, to discuss and disseminate information among other states about various ways to review and improve the review of maternal mortality. The Division is also participating in the formation of a statewide perinatal quality improvement learning collaborative, which will address issues of quality improvement in maternal and infant health care.

Evidence-based Practices

Decreasing the numbers of non-medically indicated labor induction and delivery before 39 weeks of gestation.

Routine use of sequential compression devices to help prevent blood clots in all patients delivering by Cesarean.



Related Indicators

Relevant Population Characteristics

Mothers at very young (under 18 years) and very old age (over 40 years) are at a greater risk of maternal mortality.

Related Relevant Population Characteristics Indicators:


Health Care System Factors

Inadequate prenatal care is associated with greater risk of maternal mortality.

Related Health Care System Factors Indicators:


Risk Factors

Pregnancy-related mortality for Black women is consistently higher than for White women. Older women, particularly women aged 35 years or over, are also at increased risk for pregnancy-related deaths. Women who received no prenatal care also had a higher risk of pregnancy-related mortality compared to those who received "adequate" prenatal care.

Related Risk Factors Indicators:




Graphical Data Views

Maternal Mortality Rate, Utah and U.S., 1999-2012

::chart - missing::

Geog: Utah vs. U.S. Year Deaths per 100,000 Live Births
Record Count: 33
Utah 1999 10.8
Utah 2000 10.6
Utah 2001 12.5
Utah 2002 12.2
Utah 2003 16.1
Utah 2004 7.9
Utah 2005 13.6
Utah 2006 20.6
Utah 2007 16.3
Utah 2008 14.4
Utah 2009 16.7
Utah 2010 17.3
Utah 2011 11.7
Utah 2012 11.7
U.S. 1999 9.9
U.S. 2000 9.8
U.S. 2001 9.9
U.S. 2002 8.9
U.S. 2003 12.1
U.S. 2004 13.4
U.S. 2005 15.1
U.S. 2006 13.3
U.S. 2007 12.7
U.S. 2008 15.5
U.S. 2009 17.8

Data Notes

Wide fluctuations in Utah rates may be attributable to the small numbers involved.

Maternal death cases are identified in the following manner: all death certificates for women of childbearing years (ages 10-50) regardless of cause are linked to fetal death and/or infant birth/death certificates when the delivery occurred within one year of the maternal death. The certificates are reviewed to determine whether the maternal death was related to pregnancy. In some cases medical records are needed to determine this. The maternal death rate for this Indicator Report is not limited to the death certificate checkbox or cause of death ICD-10 codes only. Cases are hand calculated every year to help ensure accuracy.   Figures for U.S. maternal mortality for 2010 are not yet available.
U.S. figures from CDC Pregnancy Mortality Surveillance System.

Data Sources

Office of Vital Records and Statistics, Utah Department of Health. National Vital Statistics System, National Center for Health Statistics, U.S. Centers for Disease Control and Prevention.


References and Community Resources

Berg, C.J.; Atrash, H.K.; Koonin, L.M. Pregnancy-related mortality in the United States, 1987-1990. Obstet Gynecol 1996; 88:161-7

World Health Organization. WHO revised 1990 estimates of maternal mortality: a new approach by WHO and UNICEF. Geneva, Switzerland: World Health Organization, 1996; WHO/FRH/MSM/96.11

More Resources and Links

Evidence-based community health improvement ideas and interventions may be found at the following sites:

Additional indicator data by state and county may be found on these Websites:

Medical literature can be queried at the PubMed website.

For an on-line medical dictionary, click on this Dictionary link.

Page Content Updated On 02/05/2014, Published on 03/24/2014
The information provided above is from the Utah Department of Health's Center for Health Data IBIS-PH web site (http://ibis.health.utah.gov). The information published on this website may be reproduced without permission. Please use the following citation: "Retrieved Fri, 31 October 2014 23:17:32 from Utah Department of Health, Center for Health Data, Indicator-Based Information System for Public Health Web site: http://ibis.health.utah.gov".

Content updated: Mon, 24 Mar 2014 11:45:42 MDT