United States US: Maternal Mortality Ratio: Modeled Estimate: per 100,000 Live Births data was reported at 14.000 Ratio in 2015. This stayed constant from the previous number of 14.000 Ratio for 2014. United States US: Maternal Mortality Ratio: Modeled Estimate: per 100,000 Live Births data is updated yearly, averaging 13.000 Ratio from Dec 1990 (Median) to 2015, with 26 observations. The data reached an all-time high of 15.000 Ratio in 2009 and a record low of 11.000 Ratio in 1998. United States US: Maternal Mortality Ratio: Modeled Estimate: per 100,000 Live Births data remains active status in CEIC and is reported by World Bank. The data is categorized under Global Database’s USA – Table US.World Bank: Health Statistics. Maternal mortality ratio is the number of women who die from pregnancy-related causes while pregnant or within 42 days of pregnancy termination per 100,000 live births. The data are estimated with a regression model using information on the proportion of maternal deaths among non-AIDS deaths in women ages 15-49, fertility, birth attendants, and GDP.; ; WHO, UNICEF, UNFPA, World Bank Group, and the United Nations Population Division. Trends in Maternal Mortality: 1990 to 2015. Geneva, World Health Organization, 2015; Weighted average; This indicator represents the risk associated with each pregnancy and is also a Sustainable Development Goal Indicator for monitoring maternal health.

Maternal mortality is widely considered an indicator of overall population health and the status of women in the population. DOHMH uses multiple methods including death certificates, vital records linkage, medical examiner records, and hospital discharge data to identify all pregnancy-associated deaths (deaths that occur during pregnancy or within a year of the end of pregnancy) of New York state residents in NYC each year. DOHMH convenes the Maternal Mortality and Morbidity Review Committee (M3RC), a multidisciplinary and diverse group of 40 members that conducts an in-depth, expert review of each pregnancy-associated death of New York state residents occurring in NYC from both clinical and social determinants of health perspectives. The data in this table come from vital records and the M3RC review process. Data are not cross-classified on all variables: cause of death data are available by the relation to pregnancy (pregnancy-related, pregnancy-associated but not related, unable to determine), race/ethnicity and borough of residence data are each separately available for the total number of pregnancy-associated deaths and pregnancy-related deaths only.

In 2023, non-Hispanic Black women had the highest rates of maternal mortality among select races/ethnicities in the United States, with 50.3 deaths per 100,000 live births. The total maternal mortality rate in the U.S. at that time was 18.6 per 100,000 live births, a decrease from a rate of almost 33 in 2021. This statistic presents the maternal mortality rates in the United States from 2018 to 2023, by race and ethnicity.

ObjectiveTo determine which characteristics and circumstances were associated with very early and second-trimester abortion.MethodsPaper and pencil surveys were collected from a national sample of 8,380 non-hospital U.S. abortion patients in 2014 and 2015. We used self-reported LMP to calculate weeks gestation; when LMP was not provided we used self-reported weeks pregnant. We constructed two dependent variables: obtaining a very early abortion, defined as six weeks gestation or earlier, and obtaining second-trimester abortion, defined as occurring at 13 weeks gestation or later. We examined associations between the two measures of gestation and a range of characteristics and circumstances, including type of abortion waiting period in the patients’ state of residence.ResultsAmong first-trimester abortion patients, characteristics that decreased the likelihood of obtaining a very early abortion include being under the age of 20, relying on financial assistance to pay for the procedure, recent exposure to two or more disruptive events and living in a state that requires in-person counseling 24–72 hours prior to the procedure. Having a college degree and early recognition of pregnancy increased the likelihood of obtaining a very early abortion. Characteristics that increased the likelihood of obtaining a second-trimester abortion include being Black, having less than a high school degree, relying on financial assistance to pay for the procedure, living 25 or more miles from the facility and late recognition of pregnancy.ConclusionsWhile the availability of financial assistance may allow women to obtain abortions they would otherwise be unable to have, it may also result in delays in accessing care. If poor women had health insurance that covered abortion services, these delays could be alleviated. Since the study period, four additional states have started requiring that women obtain in-person counseling prior to obtaining an abortion, and the increase in these laws could slow down the trend in very early abortion.

IntroductionAntenatal exercise can reduce gestational weight gain, backache; pregnancy induced medical disorders, caesarean section rates, and improves pregnancy outcomes. American College of Obstetrics and Gynecology (ACOG) recommends prenatal exercise, which is associated with minimal risk and has been shown to be beneficial for pregnancy outcomes, although some exercise routines may need to be modified. Consequently, this meta-analysis is intended to verify the pooled practice of antenatal exercise in Africa using available primary articles.MethodsGenuine search of the research articles was done via PubMed, Scopes, Cochrane library, the Web of Science; free Google databases search engines, Google Scholar, and Science Direct databases. Published and unpublished articles were searched and screened for inclusion in the final analysis and Studies without sound methodologies, and review and meta-analysis were not included in this analysis. The Newcastle–Ottawa scale was used to assess the risk of bias. If heterogeneity exceeded 40%, the random effect method was used; otherwise, the fixed-effect method was used. Meta-analysis was conducted using STATA version 14.0 software. Publication bias was checked by funnel plot and Egger test.ResultsThis review analyzed data from 2880 women on antenatal care contact from different primary studies. The overall pooled effect estimate of antenatal exercise in Africa was 34.50(32.63–36.37). In the subgroup analysis for pooled antenatal exercise practice by country, it was 34.24 (31.41–37.08) in Ethiopia and 37.64(34.63–40.65) in Nigeria.ConclusionThe overall pooled effect estimate of antenatal exercise in Africa was low compared to other continent. As it was recommended by ACOG antenatal exercise to every patient in the absence of contraindications, it should be encouraged by professionals providing antenatal care service.

BackgroundRecurrent pregnancy loss (RPL) presents a major challenge in reproductive medicine, with lifestyle factors, especially dietary patterns, potentially influencing pregnancy outcomes. This study aimed to explore the relationship between adherence to preconception dietary patterns and pregnancy outcomes in women with RPL.MethodsThe study included 475 women with RPL at Renji Hospital, Shanghai Jiao Tong University School of Medicine. Participants completed a semi-quantitative food frequency questionnaire (FFQ) to assess adherence to six pre-defined dietary patterns at preconception: the American Heart Association Diet (AHA), Trichopoulou Mediterranean Diet (TMED), Panagiotakos Mediterranean Diet (PMED), Alternate Mediterranean Diet (AMED), Healthy Eating Index-2015 (HEI-2015), and Dietary Approaches to Stop Hypertension (DASH). Pregnancy loss, gestational diabetes mellitus (GDM), hypertensive disorders of pregnancy (HDP), and other adverse pregnancy outcomes (APO) (e.g., preterm birth, low birth weight) were ascertained using medical records.ResultsSignificant associations were observed between adherence to the AHA diet and reduced risks of pregnancy loss [adjusted RR (95% CI), highest quartile (Q4) vs. lowest quartile (Q1): 0.36 (0.17, 0.78), P-trend = 0.043], GDM [adjusted RR (95% CI), highest quartile (Q4) vs. lowest quartile (Q1): 0.28 (0.10, 0.75), P-trend = 0.006], HDP [adjusted RR (95% CI), highest quartile (Q4) vs. lowest quartile (Q1): 0.12 (0.03, 0.57), P-trend = 0.008], and other adverse pregnancy outcomes [adjusted RR (95% CI), highest quartile (Q4) vs. lowest quartile (Q1): 0.04 (0.01, 0.35), P-trend = 0.001]. Similar associations were found for the AHEI, AMED, and TMED diets regarding pregnancy loss, GDM, and HDP, while the PMED and DASH diets showed no significant associations. Additionally, higher levels of moderate-to-vigorous physical activity and lower energy and fat intake were associated with increased live birth rates.ConclusionGreater adherence to the AHA diet during the preconception period was linked to lower risks of pregnancy loss, and adverse pregnancy outcomes. These findings support the AHA diet for patients with recurrent pregnancy loss, indicating that healthy dietary patterns may improve pregnancy outcomes and highlight the need for further research on their impact on fertility.

Abstract

This study sought to develop a user-friendly decision-making tool to explore country-specific estimates for costs and economic consequences of different options for scaling screening and psychosocial interventions for women with common perinatal mental health problems in Malawi. We developed a simple simulation model using a structure and parameter estimates that were established iteratively with experts, based on published trials, international databases and resources, statistical data, best practice guidance and intervention manuals. The model projects annual costs and returns to investment from 2022 to 2026. The study perspective is societal, including health expenditure and productivity losses. Outcomes in the form of health-related quality of life are measured in Disability Adjusted Life Years, which were converted into monetary values. Economic consequences include those that occur in the year in which the intervention takes place. Results suggest that the net benefit is relatively small at the beginning but increases over time as learning effects lead to a higher number of women being identified and receiving (cost‑)effective treatment. For a scenario in which screening is first provided by health professionals (such as midwives) and a second screening and the intervention are provided by trained and supervised volunteers to equal proportions in group and individual sessions, as well as in clinic versus community setting, total costs in 2022 amount to US$ 0.66 million and health benefits to US$ 0.36 million. Costs increase to US$ 1.03 million and health benefits to US$ 0.93 million in 2026. Net benefits increase from US$ 35,000 in 2022 to US$ 0.52 million in 2026, and return-on-investment ratios from 1.05 to 1.45. Results from sensitivity analysis suggest that positive net benefit results are highly sensitive to an increase in staff salaries. This study demonstrates the feasibility of developing an economic decision-making tool that can be used by local policy makers and influencers to inform investments in maternal mental health

Description of data set

Iteratively, information was gathered from desk-based searches and from talking to and exchanging emails with experts in the maternal health field to establish a model structure and the parameter values. This included the development of an information request form that presents a list of parameters, parameter values and details about how the values were estimated and the data sources. We collected information on: Intervention’s effectiveness; prevalence rates; population and birth estimates; proportion of women attending services; salaries and reimbursement rates for staff and volunteers; details about training, supervision, intervention delivery (e.g., frequency, duration); unit costs, and data needed to derive economic consequences (e.g. women’s income, health weights). Data were searched from the following sources: published randomised controlled trials and meta-analyses; WHO published guidance and intervention manual; international databases and resources (WHO-CHOICE, Global Burden of Disease Database; International Monetary Fund; United Nations Treasury, World Bank, Global Investment Framework for Women’s and Children’s Health). We consulted two groups of experts: one group included individuals with clinical, research or managerial expertise in funding, managing, delivering, or evaluating screening of common mental health problems and PSIs; the second group included individuals from the Malawi Government, Ministry of Health Reproductive Health Unit and Non-Communicable Disease Committee and Mental Health Unit. The first group of experts provided information from research and administrative data systems concerned with implementing and evaluating screening for maternal mental health and the delivery of interventions. The second group of experts from the Malawi Government provided information on unit costs for hospital use and workforce data, as well as information on how training and supervision might be delivered at scale. Individuals were identified by colleagues of this team based or part-time based in Malawi, which included a psychiatrist specialising in perinatal mental health (co-author RS) and the coordinator of the African Maternal Mental Health Alliance (co-author DN), an organisation concerned with disseminating information and evidence on perinatal mental health to policy makers and influencers, and the wider public.

Number and percentage of live births, by month of birth, 1991 to most recent year.

ABSTRACT Objective: Universal screening for thyroid dysfunction in pregnant women is not recommended by the American Thyroid Association (ATA) or the American Association of Clinical Endocrinologists (AACE). This study evaluated the frequency of pregnant women that would have an indication for levothyroxine (L-T4) according to the new ATA/AACE guidelines among low-risk women without an indication for screening with TSH. Subjects and methods: The sample consisted of 412 pregnant women ranging in age from 18 to 30 years. These women were considered to be at low risk for thyroid dysfunction according to ATA/AACE and would not be candidates for screening with TSH. Anti-thyroid peroxidase antibodies (TPOAb) and TSH were measured. Women who had TSH > 2.5 mIU/L or TPOAb in the first trimester were submitted to subsequent evaluations in the second and third trimester. Results: In the first trimester, none of the pregnant women would have L-T4 therapy “recommended” and treatment would be “considered” in only two. In the second trimester, pregnant women with positive TPOAb or TSH > 2.5 mIU/L in the first trimester (n = 30) were reevaluated. L-T4 treatment would be “recommended” in only one woman and would be “considered” in two others. The 28 women that were not treated in the second trimester were reevaluated in the third trimester, but none of them would have L-T4 “recommended”. Conclusion: The findings of the study suggest that selective screening, recommended by ATA/AACE does not result in a significant loss of pregnant women with an indication for L-T4 treatment.