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Maternal Morbidity and Mortality

Narrative

Diabetes and hypertension are the most commonly reported health conditions among pregnant women. Diabetes, both chronic and gestational (developing only during pregnancy), may pose health risks to a woman and her baby. Women with gestational diabetes are at increased risk for developing diabetes later in life.1 In 2008, among the 27 states that collected this information on the revised birth certificate, chronic or pre-existing diabetes occurred at a rate of 6.5 per 1,000 live births while gestational diabetes was a complication in 40.6 per 1,000 live births. Chronic diabetes was highest among non-Hispanic American Indian/Alaska Native mothers (17.7 per 1,000 live births) and lowest among non-Hispanic White and non-Hispanic Asian mothers (5.9 per 1,000). However, non-Hispanic Asian mothers had the highest rate of gestational diabetes at 70.7 per 1,000 live births, followed by non-Hispanic Native Hawaiian/Pacific Islander and non-Hispanic American Indian/Alaska Native mothers (53.0 and 50.3 per 1,000, respectively).

Hypertension during pregnancy can also be either chronic in nature or gestational. Severe hypertension during pregnancy can result in preeclampsia, fetal growth restriction, and early delivery.2 In 2008, in the 27 states that used the revised birth certificate, chronic and pregnancy-associated hypertension were present in 11.1 and 38.7 per 1,000 live births, respectively. Chronic hypertension was most common among non-Hispanic Black women (22.8 per 1,000 live births) and least common among Hispanic and non-Hispanic Asian women (5.9 and 5.5 per 1,000, respectively). Pregnancy-associated hypertension exceeded a rate of 40 per 1,000 live births among non-Hispanic White, non-Hispanic Black, and non-Hispanic American Indian/Alaska Native mothers and was lowest among non-Hispanic Asian mothers (19.7 per 1,000).

In 2007, there were 548 maternal deaths (12.7 per 100,000 live births) related to or aggravated by pregnancy which occurred during or within 42 days after the end of the pregnancy.3 This does not include 221 deaths of women that were due to complications during pregnancy or childbirth and that occurred after 42 days postpartum, or the deaths of pregnant women due to external causes such as unintentional injury, homicide, or suicide. The maternal mortality rate among non-Hispanic Black women (28.4 per 100,000 live births) was roughly 3 times the rates among non-Hispanic White and Hispanic women (10.5 and 8.9 per 100,000, respectively—see Child Health USA 2011 for more detail).

1 Centers for Disease Control and Prevention. Diabetes in Pregnancy. Accessed 06/27/11.
2 American Congress of Obstetricians and Gynecologists.External Web Site Policy High Blood Pressure During Pregnancy. Accessed 06/27/11.
3 Xu JQ, Kochanek KD, Murphy SL, Tejada-Vera B. Deaths: Final data for 2007. National vital statistics reports; vol 58 no 19. Hyattsville, MD: National Center for Health Statistics. 2010.

Graph

Data

Selected Maternal Morbidities and Risk Factors in Pregnancy, by Race/Ethnicity, 2008*
Race/Ethnicity Rate per 1,000 Live Births
Chronic Diabetes Gestational Diabetes Chronic Hypertension Pregnancy Associated Hypertension
*Data are from 27 states that implemented the 2003 revision of the birth certificate, representing 65% of all U.S. births.
Source: Centers for Disease Control and Prevention, National Center for Health Statistics. 2008 Natality Public Use File. Analysis conducted by the Maternal and Child Health Information Resource Center; Centers for Disease Control and Prevention, National Center for Health Statistics, Division of Vital Statistics. 2008 Natality File. Unpublished data for Asian and Native Hawaiian Pacific Islander populations.
Non-Hispanic White 5.9 39.1 11.7 44.0
Non-Hispanic Black 9.2 34.9 22.8 49.2
Hispanic 6.4 40.2 5.9 28.6
Non-Hispanic American Indian/Alaska Native 17.7 50.3 14.2 47.4
Non-Hispanic Asian 5.9 70.6 5.6 19.7
Non-Hispanic Native Hawaiian/Other Pacific Islander 7.1 52.6 10.3 39.6
Total 6.5 40.6 11.1 38.7

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