APHA
Back to Annual Meeting Page
 
American Public Health Association
133rd Annual Meeting & Exposition
December 10-14, 2005
Philadelphia, PA
APHA 2005
 
4263.0: Tuesday, December 13, 2005 - Board 8

Abstract #115243

Maternal mortality in New York City: Increased case ascertainment with enhanced surveillance

Gina M. Brown, MD, Katrina Manzano, MPH, and Deborah L. Kaplan, RPA, MPH. Maternal, Infant and Reproductive Health Program, New York City Department of Health, 2 Lafayette Street, 18th floor, New York, NY 10007, 212-442-1779, gbrown@health.nyc.gov

Background: Maternal mortality (MM) surveillance is conducted at a statewide level and reported nationally. Case ascertainment methods vary. Some states require active surveillance (review of suspect case reports) for maternal deaths; others rely on data from death certificates only. All methods result in some under-reporting.  New ICD 10 coding extends the definition of MM to include deaths up to one year following delivery/termination.  This delineates “pregnancy-related” deaths from “pregnancy-associated” (incidental deaths not due to pregnancy status). Methods: In 1998, the New York City (NYC) Department of Health and Mental Hygiene introduced enhanced surveillance (ES) for maternal deaths. All potential maternal deaths between 1998 and 2000 were reviewed. ES supplemented Bureau of Vital Statistics (BVS) data with medical examiner (ME) and hospital discharge data (SPARCS). ICD 9 and 10 coding was applied. Results: ES of MM cases between 1998-2000 increased overall case ascertainment by 70%. Cases were doubled in 1998, increased by 28% in 1999, and increased by 59% in 2000. <># Cases Maternal Deaths by Referral Source and Classification (1998-2000) 

Source

Pregnancy Related

Pregnancy Associated

Total

BVS

91

17

108

ME

10

22

32

SPARCS

18

8

26

Total

119

47

166 *

* Missing-3

Pregnancy-related cases were increased by 36%. Pregnancy-associated cases were increased by 176%. The use of ES allowed the identification of race, hemorrhage, and obesity as important correlates of MM.

Conclusions: BVS and death certificate data undercount MM. ES increases ascertainment of pregnancy related and associated deaths and improves the assessment of causal associations.

Learning Objectives:

Keywords: Maternal Health, Surveillance

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.

Maternal, Infant and Child Health Epidemiology: Poster Session

The 133rd Annual Meeting & Exposition (December 10-14, 2005) of APHA