The United States has the highest rate of pregnancy-related deaths among high-income countries, and a new study shows these "largely preventable" deaths have risen in recent years.
Maternal mortality in the U.S. increased by nearly 28% from 2018 to 2022, according to research published Wednesday in JAMA Network Open. Almost one-third of the deaths took place more than six weeks after childbirth. There also were large disparities reported based on race, ethnicity and state.
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Researchers said these maternal death rates in the U.S. should be an "urgent public health priority."
The study analyzed 6,283 pregnancy-related deaths, relying on data from the Centers for Disease Control and Prevention's Division of Reproductive Health, most of which was shuttered by the Trump administration last week. That division studied maternal health and aimed to understand and narrow disparities.
"It's a hard time for this to come out," Rose Molina, an OB-GYN at Harvard Medical School, who co-authored the study, told STAT. "We cannot take our eyes off of maternal health right now, and if anything, we need to not just maintain focus, but actually increase investment in maternal health to bring down some of what we're seeing — increases in pregnancy-related death rates, but also persistent inequities by racial and ethnic groups."
Cardiovascular disease was the leading cause of pregnancy-related deaths overall, and late maternal deaths, defined as deaths occurring from six weeks to a year after childbirth. Pregnancy can affect the cardiovascular system and provoke underlying conditions, like hypertension.
The surge in deaths was observed across all age groups in the study, and peaked in 2021 amid the COVID-19 pandemic, but there was a disproportionate increase in deaths among women ages 25 to 39 years. This may be because cardiovascular disease is becoming more prevalent in younger adults, as people are getting "sicker earlier," Molina told the New York Times.
Cancer, mental and behavioral health disorders and drug- and alcohol-induced deaths also were found to be "important contributing causes" of late maternal death. Homicides, suicides, vehicular crashes and other incidental causes of death were not included in the analysis, because they are not considered medically related to pregnancy, the study said.
Researchers also detailed the widening disparities in pregnancy-related deaths. Native American and Alaska Native women had the highest rates, and were 3.8 times more likely to die than white women. Black women had the second highest rate — 2.8 times higher than the rate for white women. Hispanic women and Asian women had the lowest rates of pregnancy-related deaths, the study found.
The death rates also varied by more than threefold between states. Alabama had the highest, followed by Mississippi. California had the lowest rate, followed by Minnesota. If the national rate was reduced to the rate in California, 2,679 pregnancy-related deaths could have been prevented from 2018 to 2022.
"There really shouldn't be this level of variation across the states, and we need to do better across all the states," Molina told Time. "We need to continue investing in the infrastructure (and) the policies that ensure access to high-quality pregnancy care for everyone."
