The California Pregnancy-Associated Mortality Review: Report from 2002 to 2007 Maternal Death Reviews
2018 | Download
After a steady rise in maternal mortality from 1999-2006, California has observed a sustained decline in maternal mortality, from a high of 16.9 deaths per 100,000 live births in 2006 to a low of 7.3 deaths per 100,000 in 2013. This is in contrast to the rest of the nation where maternal mortality rates are triple those of California.
Released by the California Department of Public Health (CDPH), the California Maternal Quality Care Collaborative (CMQCC) and the Public Health Institute (PHI), this report is a comprehensive statewide examination of maternal deaths from 2002-2007. Clinical characteristics, causes of death, and opportunities to prevent future maternal mortality and morbidity are described.
Key findings of the Pregnancy-Associated Mortality Review for 2002-2007 include:
- Cardiovascular disease was the leading cause of pregnancy-related deaths during this study period
- Racial disparities persist: while maternal mortality for African-American women showed a 50 percent reduction, they continue to die at 3-4 times the maternal mortality rate of women of other racial/ethnic groups, and as high as 8 times the rate among cardiovascular deaths.
- Health care provider factors, such as delayed recognition of and response to clinical warning signs and patient factors such as obesity and hypertension contributed to many of the deaths.
- 41% of the pregnancy-related deaths had a good-to-strong chance of preventability.
The report finds that the rise in maternal mortality from 1999 to 2006 was largely attributable to three factors:
- Better documentation of maternal deaths on the death certificate
- Women entering pregnancy at an older age and with a greater incidence of chronic conditions and significant social risk factors
- Significant need for improvement in clinician and facility readiness to respond to certain obstetric complications