In 2020, the leading causes of pregnancy-related deaths in the United States were mental health conditions, cardiovascular conditions, and infection. These three leading underlying causes were responsible for over **** of all pregnancy-related deaths in 2020. Mental health conditions alone accounted for *********** of all pregnancy-related deaths in the U.S. showing how important it is to screen for postpartum depression. This statistic shows the percentage of pregnancy-related deaths in 38 U.S. states in 2020, by underlying cause.

In 2020, the leading causes of pregnancy-related deaths in the U.S. were different for different races and ethnicities. For example, mental health conditions were the leading cause of pregnancy-related deaths among non-Hispanic white women, while non-Hispanic Black women mostly died from cardiovascular conditions, and non-Hispanic Asian women from amniotic fluid embolism. This statistic shows the distribution of pregnancy-related deaths in 38 U.S. states in 2020, by underlying cause and ethnicity.

In 2021, a total of 13 people died due to complications following an abortion in Argentina. Meanwhile, 34 deaths were reported due to hypertension, edema or proteinuria during pregnancy, childbirth or puerperium. According to a survey carried out in the South American country in November 2020, more than a third of respondents strongly disagreed with the decriminalization of abortion.

Abstract Objective To determine the profile of maternal deaths occurred in the period between 2000 and 2019 in the Hospital de Clínicas de Porto Alegre (HCPA, in the Portuguese acronym) and to compare it with maternal deaths between 1980 and 1999 in the same institution. Methods Retrospective study that analyzed 2,481 medical records of women between 10 and 49 years old who died between 2000 and 2018. The present study was approved by the Ethics Committee (CAAE 78021417600005327). Results After reviewing 2,481 medical records of women who died in reproductive age, 43 deaths had occurred during pregnancy or in the postpartum period. Of these, 28 were considered maternal deaths. The maternal mortality ratio was 37.6 per 100,000 live births. Regarding causes, 16 deaths (57.1%) were directly associated with pregnancy, 10 (35.1%) were indirectly associated, and 2 (7.1%) were unrelated. The main cause of death was hypertension during pregnancy (31.2%) followed by acute liver steatosis during pregnancy (25%). In the previous study, published in 2003 in the same institution4, the mortality rate was 129 per 100,000 live births, and most deaths were related to direct obstetric causes (62%). The main causes of death in this period were due to hypertensive complications (17.2%), followed by postcesarean infection (16%). Conclusion Compared with data before the decade of 2000, there was an important reduction in maternal deaths due to infectious causes.

Estimates based on District hospital discharge data. Counts of and rates based on fewer than 10 births are suppressed for privacy reasons.

Source: Center for Policy Planning and Evaluation, DC Department of Health

Why This Matters

In recent decades, pregnancy-related deaths have risen in the United States. Although relatively rare and mostly preventable, the numbers are high relative to other high-income countries.

Leading underlying causes of pregnancy-related deaths include severe bleeding, cardiac and coronary conditions, and infections. Individual, social, and structural factors contribute to maternal death risk and trends, including maternal age, preexisting medical conditions, access to quality care, insurance, and longstanding racial and ethnic inequities.

Maternal mortality rates are disproportionately higher among birthing people who are Black, Indigenous, and people of color.

The District Response

Enhancements to District healthcare programs. Medicaid expansion provides greater access to prenatal care, extended postpartum Medicaid coverage for a full year, and reimbursement for doula services through all District programs. For a list of local and national resources on pregnancy and related topics, click here.

Paid family leave program providing 12 weeks to bond with a new child or care for a serious health condition, and 2 weeks specifically for prenatal care.

The District established the Maternal Mortality Review Committee, which investigates the causes of maternal deaths, and develops strategic frameworks to improve maternal health.

Abstract Introduction Maternal mortality represents an event of great magnitude in Brazil and worldwide. The occurrence of maternal death reflects the lack of access to health services and unfavorable socioeconomic conditions. Objective To correlate maternal changes and puerperal pregnancy outcome in maternal death. Methods Cross-sectional and retrospective study. We used data collected from 53 medical records of pregnant women and postpartum women who died at a Reference State Hospital in high risk gestation in Goiás. Results Mortality occurred in women aged 20 to 34 years (76%), single (55%), first pregnancy (38%), from the interior of the State (60%) and 62% had the childbirth at the institution of the study. The main obstetric causes were 55% direct and 24% indirect, being predominant in the puerperal period (83%). The maternal mortality ratio was 228.4. There was a significant association between complications at childbirth and the place of birth (P = 0.001). Conclusion The maternal death occurred in single women, of reproductive age, coming from other counties, for direct causes and in the puerperium. It is necessary to improve the access to health services in obstetrics, since most cases are preventable.

Statistics on maternal mortality are produced based on the database of causes of death. "Maternal deaths" are selected from the database via a complex procedure, which takes into account the definition given by the WHO and is described in detail in the metadata. The tenth revision of the International Classification of Diseases (ICD-10) defines maternal death as "the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and the site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management, but not from accidental or incidental causes." "Maternal deaths should be subdivided into two groups. Direct obstetric deaths: those resulting from obstetric complications of the pregnant state (pregnancy, labour and puerperium), from interventions, omissions, incorrect treatment, or from a chain of events resulting from any of the above. Indirect obstetric deaths: those resulting from previous existing disease or disease that developed during pregnancy and which was not due to direct obstetric causes, but which was aggravated by physiologic effects of pregnancy." Furthermore, the ICD-10 also defines late maternal death as "the death of a woman from direct or indirect obstetric causes more than 42 days but less than one year after termination of pregnancy." The "maternal mortality rate" is the ratio between the number of recorded direct and indirect maternal deaths over one year and the number of live birth in the same year, expressed per 100,000 live births. Late maternal deaths are not taken into account in the calculation of this ratio. Given the small and markedly variable number of cases recorded each year in Belgium, it has been decided to calculate this ratio based on the cumulated maternal deaths and live births of five consecutive years, with the ratio calculated being recorded in the middle year. When identifying these maternal deaths, the ad hoc working group, bringing together the Belgian statistical office and all data producing federated entities, did not exclude the risk of an underestimation of these deaths, based on the only statistical bulletin used as main source. It therefore asks for continued efforts to further improve the follow-up of maternal deaths, and supports the recent initiative of the College of physicians for Mother and Newborn to consider the creation of a maternal mortality register.

In 2021, it was estimated that the maternal mortality rate as a result of abortion in Argentina amounted to 0.25 deaths per 10,000 live births. Meanwhile, hypertension, edema, or proteinuria caused around 0.6 deaths per 10,000 live births in the South American country that year. As of that date, viral infections related to pregnancy were the leading cause of maternal death in Argentina, most of them related to COVID-19.

The World Health Organization (WHO) defines maternal death as the death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes.

The maternal Mortality Ratio (MMR) is defined as the number of maternal deaths during a given time period per 100,000 live births during the same time period. This dataset covers trends in MMR across major states during specified trienniums.

The number of maternal deaths and maternal mortality rates for selected causes, 2000 to most recent year.

Maternal mortality rates can vary significantly around the world. For example, in 2022, Estonia had a maternal mortality rate of zero per 100,000 live births, while Mexico reported a rate of 38 deaths per 100,000 live births. However, the regions with the highest number of maternal deaths are Sub-Saharan Africa and Southern Asia, with differences between countries and regions often reflecting inequalities in health care services and access. Most causes of maternal mortality are preventable and treatable with the most common causes including severe bleeding, infections, complications during delivery, high blood pressure during pregnancy, and unsafe abortion. Maternal mortality in the United States In 2022, there were a total of 817 maternal deaths in the United States. Women aged 25 to 39 years accounted for 578 of these deaths, however, rates of maternal mortality are much higher among women aged 40 years and older. In 2022, the rate of maternal mortality among women aged 40 years and older in the U.S. was 87 per 100,000 live births, compared to a rate of 21 among women aged 25 to 39 years. The rate of maternal mortality in the U.S. has risen in recent years among all age groups. Differences in maternal mortality in the U.S. by race/ethnicity Sadly, there are great disparities in maternal mortality in the United States among different races and ethnicities. In 2022, the rate of maternal mortality among non-Hispanic white women was about 19 per 100,000 live births, while non-Hispanic Black women died from maternal causes at a rate of almost 50 per 100,000 live births. Rates of maternal mortality have risen for white and Hispanic women in recent years, but Black women have by far seen the largest increase in maternal mortality. In 2022, around 253 Black women died from maternal causes in the United States.

Maternal Mortality Ratio per 100,000

The maternal mortality rate in Australia in 2016 was 8.5 deaths per 100,000 women giving birth. Between 2006 and 2016, 281 women were reported to have died during pregnancy or within 42 days of the end of pregnancy. The most common causes of maternal deaths in Australia are non-obstetric haemorrhage and heart disease.

Further information can be found here: https://www.aihw.gov.au/reports/mothers-babies/maternal-deaths-in-australia-2016/data

Suicide is a leading cause of maternal death during pregnancy and up to a year after birth (perinatal period). Many psychological and psychosocial risk factors for maternal suicidal ideation and behaviour have been investigated. Despite this, there have been no attempts to systematically search the literature on these risk factors. Additionally, few studies have described how the risk factors for suicidal ideation, attempted suicides and suicide deaths differ, which is essential for the development of tools to detect and target suicidal ideation and behaviour. Seven databases were searched up to June 2021 for studies that investigated the association between suicidal ideation and/or suicidal behaviour and psychological/psychosocial risk factors in pregnant and postpartum women. The search identified 17,338 records, of which 59 were included. These 59 studies sampled a total of 49,929 participants and investigated 32 different risk factors. Associations between abuse, experienced recently or during childhood, and maternal suicide ideation, attempted suicide and death were consistently reported. Social support was found to be less associated with suicide ideation but more so with suicide attempts. Identifying women who have experienced domestic violence or childhood abuse and ensuring all women have adequate emotional and practical support during the perinatal period may help to reduce the likelihood of suicidal behaviour.

ABSTRACT: Objective: To analyze the mortality trend of children under five years of age living in Brazil and regions, using the “Brazilian List of Preventable Causes of Death.” Method: Ecological time-series study of mortality rate due to preventable and non-preventable causes, with corrections for ill-defined causes and underreporting of deaths from 2000 to 2013. Results: In Brazil, preventable death rates (5.1% per year) had a higher decrease compared with non-preventable ones (2.5% per year). Preventable causes associated with proper care during pregnancy had the highest concentration of deaths in 2013 (12,267) and the second lowest average percentage reduction in the year (2.1%) and for the period (24.4%). The South and Southeast regions had the lowest mortality rates in childhood. However, the Northeast region had the highest decrease in reducible child mortality (6.1% per year) and the Midwest, the lowest (3.5% per year). Conclusion: The decrease in childhood mortality rates was expected in the last decade, suggesting the progress in the response of health systems, in addition to improvements in health conditions and social determinants. Special attention should be given to pregnancy-related causes, i.e., expand the quality of prenatal care, in particular, due to fetal and newborn deaths resulted from maternal conditions, which increased significantly in the period (8,3% per year).

Philippines maternal mortality rate for 2023 was 84.00, a 8.7% decline from 2022.

<ul style='margin-top:20px;'>

<li>Philippines maternal mortality rate for 2022 was <strong>92.00</strong>, a <strong>39.87% decline</strong> from 2021.</li>
<li>Philippines maternal mortality rate for 2021 was <strong>153.00</strong>, a <strong>73.86% increase</strong> from 2020.</li>
<li>Philippines maternal mortality rate for 2020 was <strong>88.00</strong>, a <strong>4.35% decline</strong> from 2019.</li>
</ul>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.

Colombia maternal mortality rate for 2023 was 59.00, a 20.27% decline from 2022.

<ul style='margin-top:20px;'>

<li>Colombia maternal mortality rate for 2022 was <strong>74.00</strong>, a <strong>49.66% decline</strong> from 2021.</li>
<li>Colombia maternal mortality rate for 2021 was <strong>147.00</strong>, a <strong>56.38% increase</strong> from 2020.</li>
<li>Colombia maternal mortality rate for 2020 was <strong>94.00</strong>, a <strong>42.42% increase</strong> from 2019.</li>
</ul>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.

Presents the distribution of TOTAL PERINATAL DEATHS for 2014by main Cause of Death. This table outlines numbers and per cent by stillbirths, early neonatal deaths and total perinatal deaths. The Perinatal Statistics Report 2014 is a report on national data on Perinatal events in 2014. Information on every birth in the Republic of Ireland is submitted to the National Perinatal Reporting System (NPRS). All births are notified and registered on a standard four part birth notification form (BNF01) which is completed where the birth takes place. Part 3 of this form is sent to the HPO for data entry and validation. The information collected includes data on pregnancy outcomes (with particular reference to perinatal mortality and important aspects of perinatal care), as well as descriptive social and biological characteristics of mothers giving birth. See the complete Perinatal Statistics Report 2014 at http://www.hpo.ie/latest_hipe_nprs_reports/NPRS_2014/Perinatal_Statistics_Report_2014.pdf

Presents the distribution of TOTAL PERINATAL DEATHS for 2015 by main Cause of Death. This table outlines numbers and per cent by stillbirths, early neonatal deaths and total perinatal deaths. The Perinatal Statistics Report 2015 is a report on national data on Perinatal events in 2015. Information on every birth in the Republic of Ireland is submitted to the National Perinatal Reporting System (NPRS). All births are notified and registered on a standard four part birth notification form (BNF01) which is completed where the birth takes place. Part 3 of this form is sent to the HPO for data entry and validation. The information collected includes data on pregnancy outcomes (with particular reference to perinatal mortality and important aspects of perinatal care), as well as descriptive social and biological characteristics of mothers giving birth. See the complete Perinatal Statistics Report 2015 at http://www.hpo.ie/latest_hipe_nprs_reports/NPRS_2015/Perinatal_Statistics_Report_2015.pdf

Objectives: To identify and map all trials in maternal health conducted in low- and middle-income countries (LMIC) over the 10-year period 2010-2019, to identify geographical and thematic trends, as well as compare to global causes of maternal death and pre-identified priority areas. Design: Systematic scoping review. Primary and secondary outcome measures: Extracted data included location, study characteristics and whether trials corresponded to causes of mortality and identified research priority topics. Results: Our search identified 7,269 articles, 874 of which were included for analysis. Between 2010 and 2019, maternal health trials conducted in LMICs more than doubled (50 to 114). Trials were conducted in 61 countries – 231 trials (26.4%) were conducted in Iran. Only 225 trials (25.7%) were aligned with a cause of maternal mortality. Within these trials, pre-existing medical conditions, embolism, obstructed labour, and sepsis were all under-represented when compared with number of maternal deaths globally. Large numbers of studies were conducted on priority topics such as labour and delivery, obstetric haemorrhage, and antenatal care. Hypertensive disorders of pregnancy, diabetes, and health systems and policy – despite being high-priority topics – had relatively few trials. Conclusion: Despite trials conducted in LMICs increasing from 2010 to 2019, there were significant gaps in geographical distribution, alignment with causes of maternal mortality, and known research priority topics. The research gaps identified provide guidance and insight for future research conducted in low-resource settings. Methods With support from an information specialist, a search strategy was devised to capture eligible studies (Supplemental Table 1). Search terms for maternal and perinatal health were derived from search strategies used by Cochrane Pregnancy and Childbirth to maintain and update their specialised register. We consulted the search filters developed by Cochrane EPOC to identify search terms relating to LMICs. The search strategy was applied to the Cochrane Central Register of Controlled Trials (CENTRAL), which retrieves records from PubMed/MEDLINE, Embase, CINAHL, ClinicalTrials.gov, WHO’s International Clinical Trials Registry Platform (ICTRP), KoreaMed, Cochrane Review Group’s Specialised Registers, and hand-searched biomedical sources. Searching CENTRAL directly had the benefit of restricting search results to trials only, keeping the volume of citations to screen to a manageable level. Trial register records from ClinicalTrials.gov and WHO ICTRP were not included in the records retrieved from CENTRAL. The search was conducted on 1 May 2020. Citation management, identification of duplicates, and screening articles for eligibility were conducted using EndNote and Covidence. Two reviewers independently screened titles and abstracts of all retrieved citations to identify those that were potentially eligible. Full texts for these articles were accessed and assessed by two independent reviewers according to the eligibility criteria. At both steps, any disagreements were resolved through discussion or consulting a third author. Data collection and analysis For each included trial we extracted information on title, author, year of publication, location where the trial was conducted (country and SDG region), unit of randomisation (individual or cluster), category of intervention, intervention level (public health, community, primary care, hospital, and health system), and category of the primary outcome(s). The intervention and outcome categories were adapted from Cochrane’s list of ‘higher-level categories for interventions and outcomes’. For trials with more than one primary outcome, we identified a single, most appropriate outcome category through discussion and consensus amongst review authors. The level of intervention was determined based on the level of the healthcare system that the trial was primarily targeting – for example, trials recruiting women at an antenatal clinic were classified as primary care level. Public health and preventative care were defined as interventions for those in the community who were well, while home; and community care was defined as interventions for those in the community who were unwell. Based on the trial’s primary objective, we tagged each trial to one of 35 maternal health topics, as well as classified them by relevance to a cause of maternal death identified by Say et al in their global systematic analysis (Box 1). Included trials were additionally categorised into global research priority topics identified by Souza et al and Chapman et al. The research priorities identified by Souza et al were ranked based on the distribution of maternal health themes across the 190 priority research questions – i.e., the theme with the most research questions was considered the highest-ranked priority topic. This mirrored the process used by Chapman et al, where research topics with the greatest representation within the 100 research questions, based on percentage, were given the highest rank. For each trial identified in our review, we used the variables extracted to classify it according to priority topics identified in Souza et al or Chapman et al, where possible (Box 1). All data were extracted by two independent reviewers, with results compared to ensure consistency and any disputes resolved through discussion or consultation with a third author. As this was a scoping review, we did not perform quality assessments on individual trials. We conducted descriptive analyses using Excel to determine frequencies of extracted variables and used line graphs to explore trends. We assessed trends over time using proportions of each variable within studies available for a given year. While we initially planned to look at trends in individual countries and interventions, many had few or no data points.

IntroductionNeonatal deaths and stillbirths are significant public health concerns in Pakistan, with an estimated stillbirth rate of 43 per 1,000 births and a neonatal mortality rate of 46 deaths per 1,000 live births. Limited access to obstetric care, poor health seeking behaviors and lack of quality healthcare are the leading root causes for stillbirths and neonatal deaths. Rehri Goth, a coastal slum in Karachi, faces even greater challenges due to extreme poverty, and inadequate infrastructure. This study aims to investigate the causes and pathways leading to stillbirths and neonatal deaths in Rehri Goth to develop effective maternal and child health interventions.MethodsA mixed-method cohort study was nested with the implementation of large maternal, neonatal and child health program, captured all stillbirths and neonatal death during the period of May 2014 till June 2018. The Verbal and Social Autopsy (VASA) tool (WHO 2016) was used to collect primary data from all death events to determine the causes as well as the pathways. Interviews were conducted both retrospectively and prospectively with mothers and caregivers. Two trained physicians reviewed the VASA form and the medical records (if available) and coded the cause of death blinded to each other. Descriptive analysis was used to categorize stillbirth and neonatal mortality data into high- and low-mortality clusters, followed by chi-square tests to explore associations between categories, and concluded with a qualitative analysis.ResultsOut of 421 events captured, complete VASA interviews were conducted for 317 cases. The leading causes of antepartum stillbirths were pregnancy-induced hypertension (22.4%) and maternal infections (13.4%), while obstructed labor was the primary cause of intrapartum stillbirths (38.3%). Neonatal deaths were primarily caused by perinatal asphyxia (36.1%) and preterm birth complications (27.8%). The qualitative analysis on a subset of 40 death events showed that health system (62.5%) and community factors (37.5%) contributing to adverse outcomes, such as delayed referrals, poor triage systems, suboptimal quality of care, and delayed care-seeking behaviors.ConclusionThe study provides an opportunity to understand the causes of stillbirths and neonatal deaths in one of the impoverished slums of Karachi. The data segregation by clusters as well as triangulation with qualitative analysis highlight the needs of evidence-based strategies for maternal and child health interventions in disadvantaged communities.