CDC report finds 3 in 5 pregnancy-related deaths are preventable

A new Centers for Disease Control and Prevention (CDC) report found that pregnancy-related deaths can occur up to a year after a woman gives birth. But no matter when they occur, the agency says about three in five pregnancy-related deaths could be prevented.

Released last week, the Vital Signs report found that of the 700 pregnancy-related deaths that occur each year in the United States, about 31% take place during pregnancy, 36% happen during delivery or the week after, and 33% occur one week to one year after delivery. Heart disease and stroke caused 34% of the deaths, with other causes including infections and severe bleeding. The leading causes of death varied based on the timing of the pregnancy-related death.

The report is based on a CDC analysis of 2011-2015 national data on pregnancy mortality and 2013-2017 data from 13 state maternal mortality review committees (MMRC). Pregnancy-related death is defined by the CDC as any death of a woman during pregnancy or within one year of the end of pregnancy from a pregnancy complication; a chain of events initiated by pregnancy; or the aggravation of an unrelated condition by the physiologic effects of pregnancy.

There are persistent racial disparities, the report found. African-American and American Indian/Alaska Native women were about three times as likely to die from a pregnancy-related cause as white women.

“Ensuring quality care for mothers throughout their pregnancies and postpartum should be among our nation’s highest priorities,” said CDC Director Robert R. Redfield, MD, in a release. “Though most pregnancies progress safely, I urge the public health community to increase awareness with all expectant and new mothers about the signs of serious pregnancy complications and the need for preventative care that can and does save lives.”

According to the CDC, several contributing factors must be addressed to prevention deaths during pregnancy, at labor and delivery, and in the postpartum period:

• Providers can help patients manage chronic conditions and have ongoing conversations about warning signs of complications.
• Hospitals and health systems can encourage cross-communication and collaboration among healthcare providers. In addition, they can work to improve the delivery of quality care before, during, and after pregnancy and standardize response approaches for obstetric emergencies.
• States and communities can address social determinants of health, including providing access to housing and transportation. The CDC also urges the development of policies to ensure that high-risk women are delivered at hospitals with specialized healthcare providers and equipment; the agency says states should also support MMRCs to review the causes behind every maternal death and identify actions to prevent future deaths.
• Women and their families can know and communicate about the warning symptoms of complications and note their recent pregnancy history any time they receive medical care in the year after delivery.

The Joint Commission has also taken an interest in pregnancy deaths, with new rules on testing expecting mothers for diseases such as HIV.