by Elana Gotkine

Delivery-related mortality decreased from 2008 to 2021, while the prevalence of severe maternal morbidity (SMM) increased, according to a study published online June 22 in JAMA Network Open.

Dorothy A. Fink, M.D., from the U.S. Department of Health & Human Services in Washington, D.C., and colleagues describe trends and risk factors for delivery-related maternal deaths and SMM in the United States in a retrospective cross-sectional study. A total of 11,628,438 unique hospital discharges were analyzed.

The researchers found that from quarter (Q)1 2008 to Q4 2021, there was a decrease in regression-adjusted maternal mortality per 100,000 discharges, from 10.6 to 4.6 deaths. Patients with advanced maternal age had significantly higher mortality (e.g., adjusted odds ratio, 1.49 for age 35 to 44 versus 25 to 34 years). Cesarean delivery, comorbid conditions, complications, and COVID-19 diagnosis were also significant risk factors for mortality (e.g., adjusted odds ratio, 2.28 for cesarean delivery). From Q1 2008 to Q4 2021, there was an increase seen in the prevalence of any SMM, from 146.8 to 179.8 per 10,000 discharges. Risk factors for SMM included age 24 years or younger, age 35 years or older, belonging to a racial or ethnic minority group, cesarean delivery, Medicaid insurance, and having at least one comorbidity.

"As current national strategies increasingly focus on improving delivery-related maternal outcomes among high-risk groups, including racial and ethnic minority groups, it will become important to evaluate the effectiveness of these strategies in reducing occurrences of maternal mortality and SMM," the authors write.

More information: Dorothy A. Fink et al, Trends in Maternal Mortality and Severe Maternal Morbidity During Delivery-Related Hospitalizations in the United States, 2008 to 2021, JAMA Network Open (2023). DOI: 10.1001/jamanetworkopen.2023.17641

Journal information: JAMA Network Open 

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