Pregnancy-related death and health care services☆
Section snippets
Materials and methods
North Carolina uses a comprehensive approach to identify potential pregnancy-related deaths. This surveillance system identifies all death certificates with any mentioned cause of death related to a pregnancy complication (International Classification of Diseases, 9th Revision, codes 630–676) or with any other indication that the decedent was currently or recently pregnant. In addition, records of all deaths occurring in females between the ages of 10 and 50 are electronically matched with
Results
For the population during this 7-year period, the pregnancy-associated mortality ratio was 54.7 deaths per 100,000 live births. The pregnancy-related mortality ratio was 20.7 deaths per 100,000 live births.
The distribution of primary predictor variables among cases and controls is shown in Table 1. The crude and adjusted ORs for pregnancy-related death associated with each of these variables are shown in Table 2. There was no association between Maternity Care Coordination or Women, Infants,
Discussion
This study is unique in several respects. It comes from a contemporary and geographically defined population and is one of the few case–control studies examining the associations between pregnancy-related death and multiple health care services factors. Cases were identified using three methods, including electronic linkage of birth and death files. All pregnancy-related deaths were validated by an expert panel. Adjustments were made for confounders in the analysis.
We used birth certificate
References (22)
- et al.
Maternal mortality in developed countriesNot just a concern of the past
Obstet Gynecol
(1995) - et al.
Pregnancy-related mortality in the United States, 1987–1990
Obstet Gynecol
(1996) - et al.
Perinatal and maternal mortality in a religious group avoiding obstetric care
Am J Obstet Gynecol
(1984) Maternal mortality—United States, 1982–1996
MMWR Morb Mortal Wkly Rep
(1998)WHO revised 1990 estimates of maternal mortality: A new approach by WHO and UNICEF
(1996)- Centers for Disease Control and Prevention, National Center for Health Statistics. Vital statistics of the United...
- Centers for Disease Control and Prevention. Table 44. Maternal mortality for complications of pregnancy, childbirth and...
Healthy People 2010: Understanding and improving health
(2000)Enhanced maternal mortality surveillance—North Carolina, 1988 and 1989
MMWR Morb Mortal Wkly Rep
(1991)- et al.
Maternal mortality in United StatesReport from the maternal mortality collaborative
Obstet Gynecol
(1988)
Cited by (63)
Association between maternal death and cesarean section in Latin America: A systematic literature review
2018, MidwiferyCitation Excerpt :The positive association between cesarean section and maternal mortality in Latin America found in this review is consistent with previous studies from other geographical regions (Rubin 1981; Hall and Bewley 1999; Harper 2003; Deneux-Tharaux et al., 2006; Khan et al., 2006; Clark et al., 2008; Kamilya et al., 2010; Lumbiganon et al., 2010; Souza et al., 2010). In general, evidences from other regions showed that women who underwent cesarean section had a higher risk of severe maternal morbidity and mortality than women who underwent vaginal birth, independent of geographical area and clinical characteristics (Rubin 1981; Hall and Bewley 1999; Harper 2003; Deneux-Tharaux et al., 2006; Khan et al., 2006; Clark et al., 2008; Kamilya et al., 2010; Lumbiganon et al., 2010; Souza et al., 2010). Kamilya et al. (2010), in India, showed that cesarean section was associated with a 3.01-fold increase in the risk of maternal mortality compared with vaginal birth.
Evidence-Based Labor and Delivery Management: Can We Safely Reduce the Cesarean Rate?
2017, Obstetrics and Gynecology Clinics of North AmericaCitation Excerpt :As noted, the increase in cesarean deliveries from 1996 to 2009 pushed the overall cesarean rate in the United States well above the 15% to 20% threshold for benefit that has been identified and recommended. In addition to no improvements in maternal or neonatal mortality, there are potential morbidities from cesarean delivery, including higher risks of maternal hemorrhage and infection.22 Additionally, there are risks from a cesarean delivery on outcomes in future pregnancies.
What is the optimal gestational age for women with gestational diabetes type A1 to deliver?
2014, American Journal of Obstetrics and GynecologyUS nulliparas' perceptions of roles and of the birth experience as predictors of their delivery preferences
2013, MidwiferyCitation Excerpt :Caesarean rates substantially higher than 15% are associated with risks to reproductive health that outweigh the intended benefits (Betrán et al., 2007). Consequences of the overuse of caesarean section include increased maternal morbidity and mortality (Harper et al., 2003; Deneux-Tharaux et al., 2006; Liu et al., 2007), neonatal morbidity and mortality (Laubereau et al., 2004; Hansen et al., 2007; MacDorman et al., 2008), disruption of the attachment and breast-feeding process (Rowe-Murray and Fisher, 2001, 2002; Pérez-Ríos et al., 2008; Zanardo et al., 2010) and an increased financial burden to the health-care system (Sakala and Corry, 2008). The problem of high caesarean rates is multifaceted and complex.
Cost-effectiveness of elective induction of labor at 41 weeks in nulliparous women
2011, American Journal of Obstetrics and GynecologyShort-term and long-term effects of caesarean section on the health of women and children
2018, The LancetCitation Excerpt :Planned CS confers a lower risk of mortality compared with emergency, intrapartum CS. Although still a rare event, studies19–21 have estimated the risk of death from an emergency intrapartum CS to be up to four times higher than from vaginal birth. Further, the risk of maternal death during birth is increased in pregnancies after a CS, due to an increased risk of uterine rupture and abnormal placentation.
- ☆
Supported by grant TS-437 from the Association of Teachers of Preventive Medicine and grant 5K12HD01267 from the NICHD Women’s Reproductive Health Career Development Award.