Maternal Mortality Surveillance, United States, 1979-1986

• Published in: MMWR. Surveillance summaries 1991-07, Vol.40 (SS-2), p.1-13
• Main Authors: Koonin, Lisa M., Atrash, Hani K., Lawson, Herschel W., Smith, Jack C.
• Format: Article
• Language: English
• Subjects: Adult; Age Factors; Age groups; Causes of death; Continental Population Groups; Death; Death certificates; Female; Fetal Death - epidemiology; Humans; Live births; Maternal Mortality; Maternal mortality rates; Population Surveillance; Pregnancy; Pregnancy Outcome; Prenatal Care; Public health; Risk Factors; United States; White people
• ISSN: 1546-0738; 1545-8636; 1545-8636

To understand further the epidemiology and causes of maternal death, the Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, CDC, reviewed all identified maternal deaths in the United States, including Puerto Rico, for the period from 1979 through 1986. The maternal mortality ratio for the period was 9.1 deaths/100,000 live births. The ratios increased with age and were higher among women of black and other minority races than among white women for all age groups, particularly for women ages ≥40 years. Unmarried women had a higher risk of death than married women. Women who had received any prenatal care had a lower risk of dying than women who had received no care (RR=0.19, 95% confidence limits (CL) 0.15, 0.23). Women who received no prenatal care had a gestational age-adjusted risk of maternal death 5.7 times that of women receiving care defined as "adequate." The risk of maternal death increased with decreasing levels of education for all age groups, particularly among women ages ≥35 years. The causes of death varied for different outcomes of pregnancy; pulmonary embolism was the leading cause of death following the delivery of a live birth. Future studies aimed at developing strategies to reduce the risk of maternal deaths in the United States should use enhanced surveillance and collect more information about each death, which would allow for better understanding of factors associated with maternal mortality.