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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 2010, among the 33 States that collected this information on the revised birth certificate, chronic or pre-existing diabetes occurred at a rate of 7.0 per 1,000 live births while gestational diabetes was a complication in 44.2 per 1,000 live births. Both chronic and gestational diabetes increase significantly with maternal age to a peak among mothers aged 40 years and older of 16.7 and 97.0 per 1,000 live births, 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 2010, in the 33 States that used the revised birth certificate, chronic and pregnancy-associated hypertension were present in 12.7 and 43.4 per 1,000 live births, respectively. Chronic and pregnancy-associated hypertension were highest among mothers aged 40 or older (34.7 and 57.6 per 1,000, respectively). These conditions also varied by race and ethnicity (data not shown in graph images or in data tables on this site, but are on Women's Health USA 2011).

In 2006–2007, there were 1,294 deaths found to be pregnancy-related (15.1 per 100,000 live births), which are defined as deaths related to or aggravated by pregnancy and occurring during or within one year after the end of the pregnancy. 3 This definition includes more deaths than the traditional definition of maternal mortality, which counts pregnancy-related deaths only up to 42 days after the end of pregnancy. Cardiovascular disease was the leading cause of pregnancy-related mortality (13.5 percent) and other chronic conditions including heart muscle diseases (12.6 percent) and non-cardiovascular diseases (11.8 percent) also contributed substantially. The maternal mortality ratio among Black women was roughly 3 times the rate among White women (34.8 versus 11.0 per 100,000 live births – find more information on Child Health USA 2012).

1 Centers for Disease Control and Prevention. Diabetes in Pregnancy. Accessed 06/27/12.

2 American Congress of Obstetricians and Gynecologists. High Blood Pressure During Pregnancy. Accessed 06/27/12.

3 Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Pregnancy Mortality Surveillance System. Pregnancy-Related Mortality in the U.S. Accessed 03/02/12.

Graphs

Data

Selected Maternal Morbidities and Risk Factors in Pregnancy, by Maternal Age, 2010*
Maternal Age Rate per 1,000 Live Births
Chronic Diabetes Gestational Diabetes Chronic Hypertension Pregnancy Associated Hypertension
*Data are from 33 States that implemented the 2003 revision of the death certificate as of January 1, 2010, representing 76 percent of all U.S. births. Source: Centers for Disease Control and Prevention, National Center for Health Statistics, National Vital Statistics System
Total 7.0 44.2 12.7 43.4
Less then 20 Years 2.7 13.6 4.5 45.9
20-29 Years 5.4 33.6 9.6 42.3
30-39 Years 9.8 63.7 17.8 43.2
40 Years and Older 16.7 97.0 34.7 57.6

Leading Causes of Pregnancy-Related Death,* 2006-2007

Percent of Deaths:

  • Cardiovascular Disease: 13.5
  • Cardiomyopathy (Heart Muscle Diseases): 12.6
  • Hemorrhage (Uncontrolled Bleeding): 11.9
  • Non-Cardiovascular Diseases: 11.8
  • Hypertensive Disorders of Pregnancy: 11.1
  • Infection/Sepsis: 11.1
  • Thrombotic Pulmonary Embolism (Blood Clot in Lung): 10.9
  • Amniotic Fluid Embolism: 5.3

*The cause of death was unknown for 5.6 percent of all pregnancy-related deaths in 2006–2007.

Source: Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Pregnancy Mortality Surveillance System. Pregnancy-Related Mortality in the U.S. Accessed 03/02/2011.