On the 9th of October, A study was published in The Lancet Regional Health Americas thatย investigates the spatiotemporal patterns of maternal mortality ratios (MMRs) across the United States, which has garnered questions about the accuracy of reported data.
The U.S. has seen a rise in maternal death rates, with projections indicating a threefold increase from 1999 to 2021.ย The research points out potential issues with how maternal deaths are recorded. Specifically, the “pregnant checkbox” on death certificates may lead to misclassifications of maternal fatalities, potentially inflating the reported MMRs.
This has caused uncertainty amongst the Centers for Disease Control and Prevention (CDC)’s claims of high and increasing MMRs, suggesting they could be artifacts of flawed or inaccurate surveillance rather than true reflections of maternal health outcomes.
Due to these concerns, Researchers analyzed data from the CDC spanning from 1999 to 2021, focusing on specific-cause maternal mortality to assess the validity of MMR reports.
They reviewed 1,543 maternal deaths from 1999 to 2002 and 3,478 maternal fatalities from 2018 to 2021. The findings revealed that MMRs surged by 144% over this period, with rates climbing from 9.6 deaths per 100,000 live births to 24.
Notably, states with low MMRs, such as California, reported a smaller increase (from 7.8 to 14) compared to those with high MMRs like Texas, where rates escalated from 11 to 31.
The MMRs for specific obstetric reasons showed similar trends across states with low and high MMRs. For instance, California’s MMR was only slightly higher (10) from 2018 to 2021 compared to Texas (28.)โ
Racial disparities are stark, with MMRs increasing threefold among non-Hispanic White women and doubling among non-Hispanic Black and Hispanic women. All racial and ethnic groups experienced relative increases in MMRs from unclear causes, but the rise was particularly pronounced among non-Hispanic Black women.
The study concludes that misclassification due to the use of the pregnant checkbox in death certificates could result in exaggerated MMRs in certain states. This misreporting underscores the need for a thorough reevaluation of how maternal deaths are tracked and classified.
