Study: US maternal mortality rises 28% in 5 years, inequities persist

Editor's Note

Pregnancy-related deaths in the US rose sharply from 2018 to 2022, with rates 3.8 times higher among American Indian and Alaska Native women and 2.8 times higher among non-Hispanic Black women than among White women, according to a new study published April 9 in JAMA Network Open. Researchers estimate that 2,679 maternal deaths during the 5-year span could have been prevented if the national rate matched that of the best-performing state.

Using CDC WONDER databases, the cross-sectional study analyzed 6,283 pregnancy-related deaths, including 1,891 late maternal deaths (occurring 43 days to one year postpartum). The researchers calculated age-standardized rates per 100,000 live births and examined differences by state, age, and race/ethnicity. Key findings include:

• Pregnancy-related mortality increased 27.7%, from 25.3 deaths per 100,000 live births in 2018 to 32.6 in 2022.
• The sharpest increase (36.8%) occurred among women aged 25–39, who also accounted for the largest share of deaths.
• Alabama (59.7) and Mississippi (58.2) had the highest crude rates, while California had the lowest (18.5).
• Had the US matched California’s rate, 2,679 deaths might have been avoided during the study period.

Leading contributors to late maternal deaths include cardiovascular disorders, cancer, and mental health and substance-related deaths. Authors also highlighted hypertensive disorders and pregnancy-specific complications, which accounted for more than 20% of deaths.

Non-Hispanic Black women had the highest rates for nearly all cause categories. In this group, as well as American Indian and Alaska native women, late maternal death, disorders related to pregnancy, and hypertensive disorders accounted for more than 60% of the overall deaths. Previous data have revealed disparities in these groups that “do not appear to have improved over time,” authors wrote, possibly due to “disparities in access to postnatal care, as well as other socioeconomic and systemic challenges impacting maternal health outcomes.”

“Pregnancy-related death is a major public health concern in the US,” the authors conclude.