Maternal mortality rate among Black women three times higher than white women

The maternal mortality rate for non-Hispanic Black women was more than three times higher than it was for non-Hispanic white women, an NIH-funded analysis showed.

“Generating robust scientific evidence to guide clinical care and eliminate health disparities during and after pregnancy is a key priority for the NIH, as exemplified by its Implementing a Maternal health and PRegnancy Outcomes Vision for Everyone (IMPROVE) initiative,” National Institute of Child Health and Human Development Director Diana W. Bianchi, MD, told Healio Primary Care.

Researchers analyzed 2016 and 2017 vital statistics mortality data, including the cause-of-death literals, which are the actual words written on the death certificates. Using the actual words allowed “richer detail on the specific circumstances of death [and] detail that is often lost during standard coding processes,” Marian F. MacDorman, PhD, a research professor at the Maryland Population Research Center, and colleagues wrote in the American Journal of Public Health.

MacDorman and colleagues found that the maternal mortality rate for non-Hispanic Black women was 3.55 times that for non-Hispanic white women. Among non-Hispanic Black women, eclampsia and preeclampsia were the leading causes of death, followed by postpartum cardiomyopathy, obstetric embolism and obstetric hemorrhage. Ectopic pregnancy was the fifth-leading cause of maternal death for non-Hispanic Black women, but it was not one of the top five causes of death for non-Hispanic white and Hispanic women, according to the researchers. The risk for a non-Hispanic Black woman dying from eclampsia and preeclampsia was 5.06 times and postpartum cardiomyopathy was 4.86 times higher than it was for non-Hispanic white women.

The causes of death that most contributed to the disparity in maternal mortality between non-Hispanic Black and non-Hispanic white women were eclampsia and preeclampsia (22.1%), postpartum cardiomyopathy (19.1%) and obstetric embolism (11%). If the rates of these diseases among Black women and white women were equal, “the overall maternal mortality disparity would be reduced by 52.2%,” MacDorman and colleagues wrote.

Bianchi told Healio Primary Care that “the prominence of cardiovascular conditions among the leading causes of maternal death identified in this study, particularly for Black women, stresses the importance of improving the early diagnosis and treatment of these complications.”

MacDorman and colleagues noted that the total study population included other race and ethnic groups, but there were “insufficient numbers of deaths to support a detailed cause-of-death analysis” for those populations.

“These sobering findings highlight the urgent need to address racial and ethnic disparities in maternal deaths,” Bianchi said in a press release.

In the interview, she encouraged “health care providers, particularly non‐obstetricians, [to] take a health history that includes recent pregnancies and listen to women, especially if they have health factors that increase the risk of postpartum complications.”

References:

MacDorman MF, et al. Am J Public Health. 2021;doi:10.2105/AJPH.2021.306375.

NIH. NIH-funded study highlights stark racial disparities in maternal deaths. https://www.nih.gov/news-events/news-releases/nih-funded-study-highlights-stark-racial-disparities-maternal-deaths. Accessed Aug. 18, 2021.