Abstract P318: Wide State-By-State Variation in Maternal Mortality and Chronic Diseases That Contribute to Pregnancy Complications

Circulation ◽  
2017 ◽  
Vol 135 (suppl_1) ◽  
Author(s):  
Sarah Milder ◽  
Jamie Kenealy ◽  
Mary Ann Honors ◽  
Thomas Eckstein
Keyword(s):  
United States ◽  
Heart Disease ◽  
Mortality Rate ◽  
Maternal Mortality ◽  
Chronic Diseases ◽  
Pregnancy Complications ◽  
The United States ◽  
Reproductive Age ◽  
Maternal Mortality Rate ◽  
Live Births

Background: Among developed countries, the United States has the highest maternal mortality rate. Between 1987 and 2011, the US maternal mortality rate more than doubled from 7.2 to 17.8 deaths per 100,000 live births. More than 1,300 pregnancy-related deaths occurred in the United States in 2011-2012. Additionally, an increasing number of women have chronic health conditions, such as hypertension, diabetes, and chronic heart disease, that increase their risk of pregnancy complications, including maternal mortality. Reducing the prevalence of these diseases may be an important step toward reducing maternal mortality. To examine the current state of maternal mortality and chronic diseases in the United States, the geographical variation of these factors was examined. Methodology: State-level prevalence estimates were calculated for diabetes, heart disease, and hypertension awareness among women of reproductive age (18 to 44 years) using data from the 2013-2014 Behavioral Risk Factor Surveillance System. State-level maternal mortality rates were calculated using CDC’s 2010-2014 National Vital Statistics System. Maternal mortality was defined as the number of deaths from any cause related to or aggravated by pregnancy or its management (excluding accidental or incidental causes) during pregnancy and childbirth or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy, per 100,000 live births. Results: The maternal mortality rate is 6.8 times higher in Georgia (39.3 deaths per 100,000 live births) than in Massachusetts (5.8 deaths per 100,000 live births). Nationally, there are an estimated 19.9 maternal deaths per 100,000 live births. The prevalence of chronic diseases that increase risk of pregnancy complications also vary by state. For example, diabetes (excluding gestational diabetes) ranges from a low of 1.9% of women aged 18 to 44 in Alaska, Minnesota, and Wisconsin to a high of 4.8% in Alabama. Nationally, an estimated 3.1% of women aged 18 to 44 have been told by a doctor that they have diabetes. Conclusion: The prevalence of chronic diseases in women of reproductive age vary based on state of residence, as does the maternal mortality rate. Raising awareness about the variation in these measures is an important step toward identifying what strategies are being utilized in states with a low prevalence of diabetes, heart disease, and hypertension, and determining how their public health efforts may help those states facing challenges in these areas.

Historical and Recent Changes in Maternal Mortality Due to Hypertensive Disorders in the United States, 1979 to 2018

Hypertension ◽  
2021 ◽  
Vol 78 (5) ◽  
pp. 1414-1422
Author(s):  
Cande V. Ananth ◽  
Justin S. Brandt ◽  
Jennifer Hill ◽  
Hillary L. Graham ◽  
Sonal Grover ◽  
...  
Keyword(s):  
United States ◽  
Mortality Rate ◽  
Maternal Mortality ◽  
Birth Cohort ◽  
White Women ◽  
Gestational Hypertension ◽  
The United States ◽  
Chronic Hypertension ◽  
Maternal Deaths ◽  
Live Births

We evaluated the contributions of maternal age, year of death (period), and year of birth (cohort) on trends in hypertension-related maternal deaths in the United States. We undertook a sequential time series analysis of 155 710 441 live births and 3287 hypertension-related maternal deaths in the United States, 1979 to 2018. Trends in pregnancy-related mortality rate (maternal mortality rate [MMR]) due to chronic hypertension, gestational hypertension, and preeclampsia/eclampsia, were examined. MMR was defined as death during pregnancy or within 42 days postpartum due to hypertension. Trends in overall and race-specific hypertension-related MMR based on age, period, and birth cohort were evaluated based on weighted Poisson models. Trends were also adjusted for secular changes in obesity rates and corrected for potential death misclassification. During the 40-year period, the overall hypertension-related MMR was 2.1 per 100 000 live births, with MMR being almost 4-fold higher among Black compared with White women (5.4 [n=1396] versus 1.4 [n=1747] per 100 000 live births). Advancing age was associated with a sharp increase in MMR at ≥15 years among Black women and at ≥25 years among White women. Birth cohort was also associated with increasing MMR. Preeclampsia/eclampsia-related MMR declined annually by 2.6% (95% CI, 2.2–2.9), but chronic hypertension–related MMR increased annually by 9.2% (95% CI, 7.9–10.6). The decline in MMR was attenuated when adjusted for increasing obesity rates. The temporal burden of hypertension-related MMR in the United States has increased substantially for chronic hypertension–associated MMR and decreased for preeclampsia/eclampsia-associated MMR. Nevertheless, deaths from hypertension continue to contribute substantially to maternal deaths.

scholarly journals Safe Childbirth: A Call to Action

2019 ◽  
Vol 28 (2) ◽  
pp. 65-67
Author(s):  
Judith A. Lothian
Keyword(s):  
United States ◽  
Mortality Rate ◽  
Maternal Mortality ◽  
Maternity Care ◽  
The United States ◽  
Ongoing Research ◽  
Call To Action ◽  
Maternal Mortality Rate ◽  
System A ◽  
Safe Childbirth

Since the publication of Lamaze's Six Healthy Birth Practice papers in 2014, there has been increasing concern with the safety of the current maternity care system. A doubling of the maternal mortality rate in the United States and the continued high cesarean rate, as well as ongoing research that supports physiologic birth and identifies the risks of interfering with the physiologic process, has resulted in updated guidelines for care and has spurred advocacy efforts to transform maternity care. This article presents a number of these advocacy efforts.

scholarly journals Two year review of maternal mortality at a tertiary care hospital of GMERS, Valsad, Gujarat, India

2018 ◽  
Vol 7 (6) ◽  
pp. 2283
Author(s):  
Darshna M. Patel ◽  
Mahesh M. Patel ◽  
Vandita K. Salat
Keyword(s):  
Mortality Rate ◽  
Maternal Mortality ◽  
Rural Areas ◽  
Tertiary Care ◽  
Maternal Mortality Ratio ◽  
Care Hospital ◽  
Maternal Deaths ◽  
Maternal Mortality Rate ◽  
Live Births ◽  
Mortality Ratio

Background: According to the WHO, 80 of maternal deaths in developing countries are due to direct maternal causes such as haemorrhage, hypertensive disorders and sepsis. These deaths are largely preventable. Maternal mortality ratio (MMR) in India is 167/100,000 live births.Methods: This retrospective observational study was conducted at GMERS, Valsad. Data regarding maternal deaths from January 2016 to December 2017 were collected and analyzed with respect to epidemiological parameters. The number of live births in the same period was obtained from the labour ward ragister. Maternal mortality rate and Mean maternal mortality ratio for the study period was calculated.Results: The mean Maternal mortality rate in the study period was 413.3/100,000 births. The maternal mortality ratio (MMR) in India is 167/100,000 live births. More than half of maternal deaths were reported in multiparous patients. More maternal deaths were observed in women from rural areas (67.3%), unbooked patients (73.3%) and illiterate women (65.3%). Thirty six (69.3%) maternal death occurred during postpartum period. Most common delay was first delay (60.0%) followed by second delay (40.0%). Postpartum haemorrhage (28.8%), preeclampsia (17.3%), sepsis (13.46%) were the major direct causes of maternal deaths. Indirect causes accounted for one third of maternal deaths in our study. Anemia, hepatitis and heart disease were responsible for 13.4%, 5.7%, and 1.9% of maternal deaths, respectively.Conclusions: Majority of maternal deaths are observed in patients from rural areas, unbooked, and illiterate patients. Hemorrhage, eclampsia and sepsis are leading causes of maternal deaths. Most of these maternal deaths are preventable if patients are given appropriate treatment at periphery and timely referred to higher centers.

scholarly journals A Normalized Mortality Rate Showed the Diverse Severity of COVID-19 and Its Association With Other Chronic Diseases

2020 ◽  
Author(s):  
Santosh Kumar ◽  
P.R. Renjith ◽  
C. Priscilla ◽  
Selva Kumar Ganesan ◽  
N.G. Rajesh
Keyword(s):  
United States ◽  
Cardiovascular Diseases ◽  
Mortality Rate ◽  
Chronic Diseases ◽  
United States Of America ◽  
Respiratory Diseases ◽  
Correlation Coefficients ◽  
The United States ◽  
World Health ◽  
The World

Covid-19 has given a halt to all the activities in the world. Europe was most affected, followed by the United States of America. It has taken more than 350000 lives until now. In this study, we have assessed the severity of Covid-19 by analyzing the mortality rate of Covid-19 and other chronic diseases. The Covid-19 data and “death rate” data caused by other diseases were downloaded from the world health organization (WHO) website. A normalized method was used to see the mortality rate of Covid-19 in comparison to other diseases. The deaths caused by Covid-19 in April 2020 have overtaken the average number of deaths caused by Cancer, Cardiovascular diseases, and other diseases in Belgium, the United Kingdom (UK), Spain, France, and Ireland. Covid-19 was found to be strongly correlated with non-communicable respiratory diseases and Cancer with correlation coefficients 0.73 and 0.67 respectively. The severity of Covid-19 in the United States of America (USA) was moderate. The severity of Covid-19 in Asian countries was found to be low. Europe showed the highest diversity in the mortality rate of Covid-19. On average, except for a few European countries, Cardiovascular diseases, cancer, and non-communicable respiratory diseases were still more lethal and caused more deaths than Covid-19.

scholarly journals Mengenal Tanda-Tanda Bahaya Kehamilan di Puskesmas Pakuan Baru Kota Jambi

2021 ◽  
Vol 3 (1) ◽  
pp. 52
Author(s):  
Ria Febrina
Keyword(s):  
Mortality Rate ◽  
Maternal Mortality ◽  
Pregnant Women ◽  
Community Service ◽  
Health Workers ◽  
Obstetric Complications ◽  
Maternal Deaths ◽  
Maternal Mortality Rate ◽  
Live Births ◽  
Danger Signs

Maternal Mortality Rate (MMR) in Indonesia is still high compared to other ASEAN countries. MMR in Indonesia according to the 2017 Indonesian Demographic and Health Survey (IDHS) is 305 per 100,000 live births. The global target of SDGs (Suitainable Development Goals) is to reduce the Maternal Mortality Rate (MMR) to 70 per 100,000 live births. While in Jambi Province in 2017 recorded maternal deaths were 29 cases. Maternal deaths that occur during 90% of pregnancy are caused by obstetric complications. Direct obstetric complications are bleeding, infection and eclampsia. Indirectly maternal mortality is also influenced by delays at the family level in recognizing danger signs of pregnancy and making decisions to immediately seek help. Delay in reaching health facilities and assistance in health service facilities. Pregnancy danger signs must be recognized and detected early so that they can be handled properly because any danger signs of pregnancy can lead to pregnancy complications. Therefore it is necessary to provide counseling to improve the knowledge of pregnant women about the danger signs of pregnancy. This community service activity was carried out by Pakuan Baru Kota Jambi Public Health Center. The time of implementation in April 2020. The target is pregnant women. Community service methods include a survey and lecture approach. The results obtained are pregnant women able to understand the danger signs of pregnancy. It is recommended for health workers to continue to provide education related to pregnancy to pregnant women

scholarly journals A social law lens on maternal mortality in the U.S.: Lessons from Germany and the Netherlands

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
L Tonti
Keyword(s):  
United States ◽  
The Netherlands ◽  
Maternal Mortality ◽  
Postnatal Care ◽  
The United States ◽  
Live Births ◽  
Social Law ◽  
Insurance Benefit ◽  
Legal Interventions ◽  
The U.S

Abstract The United States has one of the worst maternal mortality rates among developed nations. American mothers are three times more likely than Canadian mothers and six times more likely than Scandinavian mothers to die from pregnancy-related deaths. Currently, for every 100,000 live births, 26.4 mothers are dying in the U.S, with significant disparities between White mothers and mothers of color. Projections indicate that by 2030, the maternal mortality rate will rise to 45 maternal deaths out of 100,000 live births. In direct contrast, most other similarly situated high-income nations have decreased their maternal mortality rates in recent years, evidencing only single-digit mortality per 100,000 mothers. This research examines how social protection measures afforded by the law can facilitate differences in these rates. Specifically, this presentation compares legal interventions enshrined in social law that impact maternal health in the United States, Germany, and the Netherlands, including mandated access to prenatal care, midwifery reimbursement, and obligatory duration of postnatal care. Compared to the United States, both Germany and the Netherlands enshrine more comprehensively midwifery compensation and access to postnatal care in their social legal codes and insurance benefit schemes. Evidence accumulated by comparing these interventions with maternal mortality statistics suggests that legal interventions that spur extra attention to mothers during and after birth may help prevent pregnancy-related deaths. It also opens a discussion about how policymakers can use legal interventions to help eliminate racial disparities in maternity practice. Key messages Codified legal interventions that mandate extra attention to mothers during and after birth may help prevent pregnancy-related deaths. Compared to the U.S., both Germany and the Netherlands better enshrine midwifery compensation and access to postnatal care in their social legal codes and insurance benefit schemes.

scholarly journals Peningkatan Pengetahuan Ibu Tentang Keluarga Berencana Dalam Perspektif Keperawatan Islami Sebagai Upaya Menekan Risiko Kehamilan

2020 ◽  
Vol 2 (2) ◽  
pp. 174-181
Author(s):  
Suko Pranowo
Keyword(s):  
Family Planning ◽  
Mortality Rate ◽  
Health Education ◽  
Maternal Mortality ◽  
Community Service ◽  
Education Intervention ◽  
Childbearing Age ◽  
Maternal Mortality Rate ◽  
Live Births ◽  
Health Education Intervention

The maternal mortality rate (MMR) is an important indicator of the degree of public health. In 2019, Indonesia's MMR was still high, namely 305 per 100,000 live births, while Indonesia's MMR target in 2015 was 102 per 100,000 live births. Problems related to pregnancy and childbirth, including the maternal mortality rate (MMR) and infant mortality rate (IMR) cannot be separated from the various factors that influence it, including maternal health status and readiness for pregnancy, antenatal examinations (pregnancy), delivery assistance. and immediate care after delivery, as well as socio-cultural factors. Pregnancy with a distance that is too close will increase the risk of bleeding, miscarriage, and postpartum death. One of the efforts to prevent it is by joining the family planning program to restore conditions after being pregnant before. This community service is carried out in RW 14, Sidanegara Village, Cilacap Tengah District. The purpose of this community service is to provide an understanding to couples of childbearing age about family planning in the view of Islamic nursing. It is hoped that couples of childbearing age can understand and finally decide to participate in family planning in order to improve the health of mothers and children. After the health education was carried out, data showed that there was a significant increase in knowledge, namely the good category before the health education intervention as many as 0 people (0%) and the good category after the health education intervention as many as 17 people (94.44%). There was an increase in the number of participants who had knowledge in good categories, namely 17 people. Has a difference in the average pre and post test knowledge value of 3.33. It is hoped that couples of childbearing age become family planning acceptors to prevent the risk of pregnancy and be able to plan their families well.    

scholarly journals Maternal Mortality Trends in Spain During the 2000-2018 Period: The Role of Maternal Origin

2021 ◽  
Author(s):  
Santiago García-Tizón Larroca ◽  
Juan Arevalo Serrano ◽  
Maria Ruiz Minaya ◽  
Pilar Paya Martinez ◽  
Ricardo Perez Fernandez Pacheco ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Maternal Mortality ◽  
Human Development ◽  
Maternal Death ◽  
Human Development Index ◽  
Descriptive Analysis ◽  
Maternal Origin ◽  
Development Index ◽  
Maternal Mortality Rate ◽  
Live Births

Abstract Backround: The available literature indicates that there are significant differences in maternal mortality according to maternal origin in high income countries. The aim of this study was to examine the trend in the maternal mortality rate and its most common causes in Spain in recent years and to analyse its relationship with maternal origin.Methods: This was a cross-sectional study of all live births as well as those resulting in maternal death in Spain during the period between 2000 and 2018. A descriptive analysis of the maternal mortality rate by cause, region of birth, maternal age, marital status, human development index and continent of maternal origin was performed. The risk of maternal death was calculated using univariate and multivariate logistic regression analyses, with adjustment for certain variables included in the descriptive analysis.Results: There was a total of 293 maternal deaths and 8,439,324 live births during the study period. The most common cause of maternal death was hypertensive disorders of pregnancy. The average maternal death rate was 3.47 per 100,000 live births. The risk of suffering from this complication was higher for immigrant women from less developed countries; therefore, a decrease of 0.01 in the maternal human development index score significantly increased the risk of this complication by 2.4%.Conclusions: The results of this study indicate that there are inequalities in maternal mortality according to maternal origin in Spain. The human development index of the country of maternal origin could be a useful tool when estimating the risk of this complication, taking into account the origin of the pregnant woman.

scholarly journals Maternal mortality rate in Bao'an district, Shenzhen, China, 1999-2018

2020 ◽  
Author(s):  
yuanfang zhu ◽  
Yali Luo ◽  
Wei Wang ◽  
Liling Wang ◽  
Yuli Cheng ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Maternal Mortality ◽  
Health Management ◽  
Maternal Deaths ◽  
Maternal Mortality Rate ◽  
Targeted Interventions ◽  
Live Births ◽  
Fast Decline ◽  
Rate Of Decline ◽  
Substantial Heterogeneity

Abstract Background China had achieved impressive success in reducing maternal mortality rate (MMR), while substantial heterogeneity still existed, and reports from Shenzhen region remained a blank. This study aiming to use all available data sources to evaluate the MMR from 1999 to 2018 in Bao’an district, Shenzhen, China. Methods Data on maternal deaths and key health-service-related indicators were obtained from registration forms and Shenzhen Maternal and Child Health Management System. The levels and trends of MMR, profiles and leading causes of death, as well as results from the maternal mortality review committee were analyzed. Results The MMR in Bao’an district declined from 95.31 per 100,000 live births in 1999 to zero in 2018, with an annualized rate of decline of 12.03% per year. A significant declining trend of MMR was observed over 5-year intervals (from 82.61 to 5.22 per 100,000 live births). MMR was higher among migrant population, women aged ≥ 35 years or those who given birth outside the hospital. The first three causes of maternal death included hemorrhage (27.69%), amniotic fluid embolism (22.31%) and internal medical disease complications (15.38%). Nearly ninety percent (86.78%) of maternal deaths were determined to be preventable. Conclusions Bao’an district had experienced a fast decline in MMR for a two-decade period, its experience in lowering MMR could provide a guideline for other regions to focus on those who needed particular attention and take targeted interventions to reduce maternal deaths.

scholarly journals Maternal mortality: A 10-year study at Nishtar Hospital Multan

2016 ◽  
Vol 11 (4) ◽  
Author(s):  
Huma Quddusi ◽  
Sajjad Masood ◽  
Sobia Mazhar ◽  
Samee Akhtar
Keyword(s):  
Mortality Rate ◽  
Maternal Mortality ◽  
Causes Of Death ◽  
Age Group ◽  
Maternal Deaths ◽  
Maternal Mortality Rate ◽  
Live Births ◽  
Causative Factors ◽  
Management Of Complications ◽  
Age Range

Objective: To analyse causes of maternal deaths and to identify preventable causes leading to this tragedy in our setup. Design: An analytical, hospital-based study. Place and duration of study: Department of Obstetric and Gynaecology, Nishter Hospital Multan from June-August 2005. Patients and methods: During the study period retrospective data was collected for period of 10 year from January 1995 to December 2004. This data was analyzed in order to determine the Maternal Mortality Rate (MMR), causes of death and characteristics of the mothers who died including her age, parity and whether they were booked or unbooked. Results: A total numbers of 30031 deliveries took place during the study period and there were 178 maternal deaths with maternal mortality rate of 593/100,000 LB (live births). 7(3.9%) patients were below the age of 20, 74(41.5%) were in the age group of 21-30 and 82(46%) in 31-40 years age range. 15(8.42%) were above the age of 40. Most of them (69%) were grand multiparas (Parity >5). The major causative factors were haemorrhage 63(35.4%), eclampsia 41(23.03%), sepsis 25(14.04%), anaemia 18(10.1%), hepatic encephalopathy 14(7.9%), abortion 11(6.2%). Majority of the patients were unbooked and presented in the hospital very late. Conclusion: A high proportion of potentially preventable maternal deaths indicate the need for improvements in education for both patient and health care provider. The provision of skilled care and timely management of complications can lower maternal mortality in our setup.

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