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Maternal mortality in the United States: Updates on trends, causes, and solutions

NeoReviews Oct 09, 2019

Collier ARY, et al. - During the past 2 decades, pregnancy-related deaths are rising in the United States which is in contrast to the declining trends observed among other high-income countries. Important causes of death comprised cardiomyopathy and other cardiovascular conditions, hemorrhage, and other chronic medical conditions. Emerging causes are unintentional death from violence, overdose, and self-harm that need medical and public health attention. In pregnancy care, there are significant racial/ethnic inequities; non-Hispanic black women vs non-Hispanic white women incur 3 to 4 times higher rates of pregnancy-related death. Given varied terminology and lack of standardized methods for identifying maternal deaths in the United States, nuanced data collection has been done and challenges are encountered in interpretation. For capturing and interpreting data on cause, timing, and preventability of maternal deaths, researchers identified state maternal mortality review committees as important mechanisms. To improve maternal health outcomes, they recommend implementation of following key interventions: 1) integrating multidisciplinary care for women with high-risk comorbidities during preconception care, pregnancy, postpartum, and beyond; 2) addressing structural racism and the social determinants of health; 3) implementing hospital-wide safety bundles with team training and simulation; 4) providing patient education on early warning signs for medical complications of pregnancy; and 5) regionalizing maternal levels of care so that women with risk factors are supported when delivering at facilities with specialized care teams.
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