Study Reveals the Need to Expand Maternal Mortality Categorization Beyond Pregnancy-Related Deaths

New Research Shows Prior Hospitalization, Severe Maternal Morbidity, and Opioid Use Disorder Were Key Contributors to Pregnancy-Associated Deaths in Massachusetts from 2002 to 2019.

BOSTON, Oct. 25, 2023 /PRNewswire-PRWeb/ -- The Center for Black Maternal Health and Reproductive Justice announced today its participation in a new study that revealed pregnancy-associated deaths as an urgent public health concern deserving greater scrutiny by maternal mortality review committees and the clinical and public health community at large. Research has found severe maternal morbidity (SMM), opioid use disorder, and prior hospital contacts were contributors to pregnancy-associated, but not pregnancy-related deaths in Massachusetts from 2002 to 2019. It also identified four times as many pregnancy-associated deaths than pregnancy-related ones and a high rate of hospital contacts (hospital admission, observational stays, and ER visits) for those who ultimately died during pregnancy through one year postpartum.

Published in the journal Obstetrics & Gynecology, the study examined deaths among Massachusetts birthing people during pregnancy or postpartum and found:

• Of the 1,291,626 deliveries during the period observed, 384 were linked to pregnancy-associated deaths.
• Pregnancy-associated but not pregnancy-related deaths (per 100,000 deliveries) were highest for birthing people with opioid use before pregnancy, severe maternal morbidity, comorbidity, or prior hospitalization.
• Individuals with pregnancy-associated deaths were also more likely to have been hospitalized before or during pregnancy.
• Among postpartum deaths, more than two-thirds (69.9%) of birthing people had hospital contact after delivery and before their death.

"There is a breakdown in the numbers of how Massachusetts maternal death rates are being reported," said Ndidiamaka Amutah-Onukagha, PhD, MPH, Julia A. Okoro Professor of Black Maternal Health in the Department of Public Health and Community Medicine at Tufts University School of Medicine and founder of the Center for Black Maternal Health and Reproductive Justice. She continued, "We're seeing much higher incidences of pregnancy-associated death; meaning a death during or within one year of pregnancy regardless of the cause. With this new research, imagine now the number of lives we can potentially save."

Dr. Eugene Declercq, professor of community health sciences at Boston University School of Public Health said, "The problem of pregnancy-associated deaths isn't just a lack of access to care, but also the inability to address the problems of high-risk individuals when they do have multiple contacts with the system. There is a clear need to expand the focus of maternal mortality to the much larger group of pregnancy-associated deaths to understand the risk factors and events that lead to many of these preventable deaths."

The study was conducted as part of the NIH Research Project Grant R01MD016026 by Tufts University School of Medicine the Department of Public Health and Community Medicine; Boston University School of Public Health; the Massachusetts Department of Public Health; Evalogic Services, Inc.; and the Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Diego.

About the Center for Black Maternal Health and Reproductive Justice

The Center for Black Maternal Health and Reproductive Justice (CBMHRJ) is the first center of its kind, in the country, to foster academic and community-engaged research with a focus on Black maternal health and eliminating inequities. Born out of the MOTHER Lab, the Center is founded and directed by Dr. Ndidiamaka Amutah-Onukagha, PhD, MPH, CHES, the Julia A. Okoro Professor of Black Maternal Health and Assistant Dean of Diversity, Equity, and Inclusion in the Department of Public Health and Community Medicine in the School of Medicine. CBMHRJ works to protect the Black birthing experience by advocating for quality, equitable, and respectful care in childbirth. The center seeks to create a world where Black women can safely, efficiently, and comfortably receive equitable access to healthcare services without having to navigate through racism and/or discrimination in medical settings.

Media Contact

Jennifer Chapple Ingram, Center for Black Maternal Health and Reproductive Justice, 1 617-636-6948, [email protected],  https://blackmaternalhealth.tufts.edu 

SOURCE Center for Black Maternal Health and Reproductive Justice