Reproductive & Maternal Health Resource Center

Reproductive & Maternal Health Resource Center

Disclosures: The authors report no relevant financial disclosures.
October 26, 2021
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Study shows mortality rates significantly increased among pregnant women from 2015 to 2019

Disclosures: The authors report no relevant financial disclosures.
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Mortality rates due to all causes and drug or alcohol poisoning significantly increased among recently pregnant women in the U.S. from 2015 to 2019, according to findings published in JAMA.

Researchers also reported that homicide-related mortality increased among recently pregnant women as well, although not significantly.

Graphical depiction of data included in article.
Howard JT, et al. JAMA. 2021;doi:10.1001/jama.2021.13971.

“While maternal mortality, that is deaths caused by pregnancy-related complications, remains higher in the U.S. than other developed nations, it has remained fairly stable over the last 5 years,” Jeffrey T. Howard, PhD, of the department of public health at the University of Texas at San Antonio, told Healio Primary Care. “However, deaths from other causes, specifically drug and alcohol poisonings and to a lesser extent homicide, have been increasing over the last 5 years. The increase in drug and alcohol mortality has been greater in pregnant and recently pregnant women than for the overall female population of childbearing ages.”

Trends in maternal mortality have been difficult to assess due to “staggered implementation of the pregnancy checkbox on death certificates between 2003 and 2017,” Howard and colleagues wrote.

Jeffrey T. Howard

They used Multiple Cause of Death files from the National Center for Health Statistics to estimate death rates among pregnant and recently pregnant women in the U.S. from 2015 to 2019. Howard and colleagues categorized women as recently pregnant if the death certificate specified that the individual was either pregnant at the time of death or died within 1 year of the end of pregnancy.

In total, 9,532 recently pregnant women died during the study period. The overall pregnancy-related mortality rate was 27.5 deaths per 100,000 live births in 2019, according to the researchers. This rate did not differ significantly from the 2015 rate, they added.

Among recently pregnant women, all-cause mortality rates increased from 44.4 to 53.9 per 100,000 live births; drug- or alcohol-related mortality rates increased from 4.3 to 8.8 per 100,000 live births; and homicide rates increased from 2 to 3.9 per 100,000 live births. The researchers reported that there was a significant increase in annual percentage change for all-cause mortality (4.4%) and drug- or alcohol-related mortality (17.4%), and a nonsignificant increase in mortality due to homicide (13.5%).

When considering all women of childbearing age, mortality rates did not significantly increase for any cause during the study period, the researchers wrote. Yet, the annual percentage changes for all-cause and drug- or alcohol-related poisoning were significantly higher for recently pregnant women than the total population of women of childbearing age.
“The trends of increasing mortality among pregnant and recently pregnant women, primarily drug and alcohol poisonings, should prompt policymakers to consider programs that address some of the underlying issues, including access to and delivery of health care, mental health issues, drug and alcohol abuse and violence,” Howard said.