Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #113989

Meena Robin Abraham, MPH and Hanan Aboumatar, MD, MPH. MedChi, The Maryland State Medical Society, 1211 Cathedral Street, Baltimore, MD 21201-5516, 410-539-0872, haboumat@jhsph.edu

Background: Maternal Mortality rates for Maryland and the United States continue to be far higher than the Healthy People 2010 goal of 3.3 deaths per 100,000 births. Maryland uses an enhanced surveillance approach as recommended by CDC and ACOG to review all pregnancy-associated deaths or deaths of women who died while pregnant or within one year of pregnancy conclusion. Methods: Pregnancy-associated deaths were identified through pregnancy checkbox on the death certificate, cause of death, linked birth and fetal death certificates, and a manual review of Medical Examiner cases. Medical records were abstracted and reviewed by one or more physicians. Select cases underwent in-depth committee review to determine pregnancy-relatedness, preventability and opportunities for prevention. Results: There were 122 pregnancy-associated deaths identified between 2000 and 2002. Thirty-nine deaths were deemed to be pregnancy-related. The leading causes of pregnancy-related deaths were cardiovascular disease, embolism and hemorrhage, and pregnancy-induced hypertension. The pregnancy-related mortality ratio was more than three times higher among black women compared to white women. Black women between 35-39 years of age were at highest risk to die as a result of pregnancy. Leading health systems factors identified were communication, discharge planning, care coordination and delivery of mental health services.

Learning Objectives:

• 1. Describe the enhanced surveillance approach to maternal mortality review in Maryland.
• 2. Define the terms used to describe deaths of women within one year of pregnancy.
• 3. Describe the characteristics of women at greater risk for pregnancy-related and pregnancy-associated deaths in Maryland.
• 4. Describe the health systems factors contributing to maternal deaths in Maryland.

Keywords: Maternal Health,

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.