Disparity ratios (comparisons of PRMR between two racial/ethnic groups) were calculated by five 2-year intervals, demographic characteristics, and state PRMR tertiles. States were anonymously classified by PRMR and grouped into lowest, middle, and highest tertiles by PRMR the PRMR was calculated by race/ethnicity per state tertile. Per the PMSS assurance of confidentiality, state-specific data are not authorized to be released. PRMRs were analyzed by age group, highest level of education, and calendar year for women who were non-Hispanic white, black, AI/AN, Asian or Pacific Islander (A/PI), and Hispanic. natality files were the source of live birth data ( 3). A death was considered pregnancy-related if it occurred during or within 1 year of pregnancy and was caused by a pregnancy complication, a chain of events initiated by pregnancy, or aggravation of an unrelated condition by the physiologic effects of pregnancy. Medically trained epidemiologists review information and determine the relatedness to pregnancy and cause for each death. Briefly, CDC requests that all states, the District of Columbia, and New York City identify deaths during or within 1 year of pregnancy and send corresponding death certificates, linked birth or fetal death certificates, and additional data when available. Methodology of PMSS has been described previously ( 2). PMSS was established in 1986 by CDC and the American College of Obstetricians and Gynecologists to better understand the causes of death and risk factors associated with pregnancy-related deaths. Strategies to address racial/ethnic disparities in pregnancy-related deaths, including improving women’s health and access to quality care in the preconception, pregnancy, and postpartum periods, can be implemented through coordination at the community, health facility, patient, provider, and system levels. Significant differences in cause-specific proportionate mortality were observed among racial/ethnic populations. Among state PRMR tertiles, the PRMRs for black and AI/AN women were 2.8–3.3 and 1.7–3.3 times as high, respectively, as those for non-Hispanic white (white) women. PRMRs for black and AI/AN women with at least some college education were higher than those for all other racial/ethnic groups with less than a high school diploma. The PRMR for black and AI/AN women aged ≥30 years was approximately four to five times that for their white counterparts. ![]() This disparity persisted over time and across age groups. ![]() Non-Hispanic black (black) and non-Hispanic American Indian/Alaska Native (AI/AN) women experienced higher PRMRs (40.8 and 29.7, respectively) than did all other racial/ethnic groups. overall PRMR was 16.7 pregnancy-related deaths per 100,000 births. ![]() Pregnancy-related mortality ratios (PRMRs) (i.e., pregnancy-related deaths per 100,000 live births) were analyzed by demographic characteristics and state PRMR tertiles (i.e., states with lowest, middle, and highest PRMR) cause-specific proportionate mortality by race/ethnicity also was calculated. Data from CDC’s Pregnancy Mortality Surveillance System (PMSS) for 2007–2016 were analyzed. Strategies to address racial/ethnic disparities in pregnancy-related deaths, including improving women’s health and access to quality care in the preconception, pregnancy, and postpartum periods, can be implemented through coordination at the community, health facility, patient and family, health care provider, and system levels.Īpproximately 700 women die in the United States each year as a result of pregnancy or its complications, and significant racial/ethnic disparities in pregnancy-related mortality exist ( 1). Identifying factors that drive differences in pregnancy-related deaths and implementing prevention strategies to address them could reduce racial/ethnic disparities in pregnancy-related mortality. ![]() What are the implications for public health practice? The cause-specific proportion of pregnancy-related deaths varied by race/ethnicity. Disparities persisted over time and across age groups and were present even in states with the lowest pregnancy-related mortality ratios and among groups with higher levels of education. Approximately 700 women die annually in the United States as a result of pregnancy or its complications racial/ethnic disparities exist.ĭuring 2007–2016, black and American Indian/Alaska Native women had significantly more pregnancy-related deaths per 100,000 births than did white, Hispanic, and Asian/Pacific Islander women.
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