PHOM Indicator Profile Report of Maternal Mortality
Why Is This Important?Approximately 700 women die each year in the United States as a result of pregnancy or delivery complications (CDC). The death of a woman during pregnancy, during or after delivery is a tragedy for her family and for society as a whole. Surveillance of maternal mortality identifies ways to improve the health, health behaviors, and health care of women before, during, and after pregnancy. Surveillance also identifies gaps in the health care system, social services, health care access, and the quality of prenatal and postnatal care.
Pregnancy-related Mortality Ratio, Utah and U.S., 1999-2017
The final determination about whether a death is categorized as pregnancy-related is made by the Utah Perinatal Mortality Review committee. Over time the composition of the committee and the information available has changed, affecting how deaths are categorized. The consensus of the committee and the current paradigm is that pregnancy profoundly affects mental health and substance abuse issues, leading those deaths to be possibly categorized as pregnancy-related. Prior to 2015, the committee may have been less likely to categorize those deaths as pregnancy-related and this may have contributed to a rise in the pregnancy-related mortality rate in recent years. Because the total number of maternal deaths is very low, the change in categorization for even one death affects the mortality rate significantly.
- 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
Data NotesMaternal death cases are identified in the following manner: all death certificates for women of childbearing years (ages 10-60) are identified. If the pregnancy checkbox is marked, there is a search for a linked fetal death and/or infant birth/death certificates within one year of the maternal death. A subset of all maternal deaths are categorized as "pregnancy-related" upon review by the Utah Perinatal Mortality Review Committee. [[br]] [[br]] The U.S. data shown here is from the CDC Pregnancy Mortality Surveillance System (PMSS), which summarizes and analyzes maternal death certificates and matching fetal death/birth certificates from 52 reporting areas. CDC data for U.S. maternal mortality for 2016 and 2017 are not yet available. [https://www.cdc.gov/reproductivehealth/maternalinfanthealth/pregnancy-mortality-surveillance-system.htm] Widely quoted, higher estimates of U.S. maternal mortality were published in the Lancet in 2016. Global, regional, and national levels of maternal mortality, 1990-2015. Kassebaum, et al.,Lancet. 2016 Oct 8;388 (10053):1775-1812. [https://www.ncbi.nlm.nih.gov/pubmed/27733286]
Risk FactorsDepression and substance use disorders were strongly associated with maternal mortality in Utah in 2015-2016. Nationally, Black women have a 3-4 times higher rate of pregnancy-related mortality than White women. 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.
How Are We Doing?The Utah pregnancy-related mortality ratio in 2015 was 25.6 (per 100,000 live births), 25.7 in 2016, and 16.5 in 2017. The leading causes of pregnancy-related deaths in Utah in 2015-2016 were drug-related deaths and suicides. The leading causes of death for 2017 have not yet been finalized.
What Is Being Done?The Utah Department of Health conducts ongoing maternal and infant mortality surveillance through the Perinatal Mortality Review program. Public education is provided on the importance of planning for pregnancy, preconception and interconception health, and recognition and treatment of maternal depression. The Utah Women and Newborns Quality Collaborative (UWNQC) addresses issues of quality improvement in maternal and infant health care.
Healthy People Objective: Reduce the rate of maternal mortalityU.S. Target: 11.4 maternal deaths per 100,000 live births
State Target: 11.4 maternal deaths per 100,000 live births