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Pregnancy-Related Deaths: A “Web of Missed Opportunities”

According to a CDC analysis of national and state data, about 700 women die every year in the US of pregnancy-related issues, and about 60% of those deaths are preventable.


 

The causes of death differ throughout pregnancy and postpartum. Overall, heart disease and stroke cause > 1 in 3 deaths. At delivery, most deaths are due to obstetric emergencies, such as severe bleeding and amniotic fluid embolism. In the week after delivery, severe bleeding, high blood pressure, and infection are most common. But one-third of the deaths happen 1 week to 1 year after delivery, most often caused by cardiomyopathy.

The findings also confirm racial disparities, the CDC says. Black and Native American women were about 3 times as likely as white women to die of a pregnancy-related cause.

The researchers analyzed 2011-2015 national data on pregnancy mortality and 2013-2017 data from 13 state maternal mortality review committees. Their analysis revealed that most pregnancy-related deaths were preventable regardless of race or ethnicity. Each death represents a “web of missed opportunities,” the CDC says. The mortality review committees determined that each death was associated with several contributing factors, including lack of access to appropriate care, missed or delayed diagnoses, and lack of knowledge among patients and providers about warning signs.

The CDC offers advice on how to help keep patients safe during and after pregnancy. For example:

  • Help patients manage their chronic conditions;
  • Teach patients about warning signs; and
  • Use tools to flag warning signs early so women can receive timely treatment

Hospitals also can standardize patient care, the CDC advises, including delivering high-risk women at hospitals with specialized providers and equipment. They can train nonobstetric providers to consider the patient’s recent pregnancy history. Importantly, health care practitioners should continue to provide high-quality care for mothers up to at least 1 year after birth.

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