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APHA Scientific Session and Event Listing

Recorded presentation

Mika Gissler¹, Catherine Deneux-Tharaux², Sophie Alexander³, Cynthia Berg⁴, Marie-Hélène Bouvier-Colle², Margaret Harper⁵, Angela Nannini⁶, Gerard Bréart², and Pierre Buekens⁷. (1) Information, STAKES National Research and Development Centre for Welfare and Health, P.O.BOX 220, Helsinki, 00531, Finland, +358-40-5033805, mika.gissler@stakes.fi, (2) U 149, Epidemiological Research Unit on Perinatal and Women’s Health, Institut National de la Santé et de la Recherche Medicale, 4, rue de la Chine, Paris, 75020, France, (3) School of Public Health CP 597, Université Libre de Bruxelles, 808, Route de Lennik, Brussels, 1070, Belgium, (4) Division of Reproductive Health, Centers for Disease Control and Prevention, Mailstop K23 Koger Bldg, Atlanta, GA 30333, (5) Department of Obstetrics and Gynecology, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, (6) Bureau of Family and Community Health, Massachusetts Department of Public Health, 715 Albany St, Boston, Boston, MA 02118, (7) School of Public Health and Tropical Medicine, Tulane University, 1440 Canal St, New Orleans, LA 70112

We compared official maternal mortality statistics with those from a special study covering all pregnancy-associated deaths in two European countries (Finland and France) and in two U.S. states (Massachusetts and North Carolina) in 1999-2000 to characterize pregnancy-related deaths that are missed in official statistics. The official maternal mortality data for 84 deaths was linked with study data on 404 pregnancy-associated deaths. Of the pregnancy-associated deaths, 151 were pregnancy related. We found 69 pregnancy-related deaths that had not been included as maternal deaths (54 definitely pregnancy-related deaths and 15 possibly pregnancy-related deaths), and we also found two deaths coded as maternal deaths that did not meet our definition for a pregnancy-related death. In total, 58 of the 69 "missed" deaths were from medical causes and 11 were from external causes or injuries. The "missed" deaths due to medical causes included 27 direct, 15 indirect, and two either direct or indirect pregnancy-related deaths and 14 possibly pregnancy-related deaths. The most common causes of the "missed" deaths due to medical causes were intracerebral hemorrhage (7 deaths), peripartum cardiomyopathy (4), pulmonary embolism (4) and pregnancy-induced hypertension (4). "Missed" pregnancy-related deaths due to injury included 10 postpartum depression-related suicides and one accidental drug poisoning (7% of all pregnancy-related deaths). Two nonpregnancy-related deaths were incorrectly reported as maternal deaths. The collection and analyzing of pregnancy-related deaths improves data on maternal deaths. The use of various data-collection methods may substantially increase the quality of maternal mortality statistics.

Learning Objectives: At the conclusion of the session, the participant (learner) in this session will be able to

• Recognize the quality problems related to statistics on maternal deaths and pregnancy-related deaths.
• Identify methods to improve maternal mortality statistics.
• Create and develop a system to improve routine data collection on maternal deaths.

Keywords: Mortality, Health Information Systems

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation