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Racial disparities in national maternal mortality trends in the United States from 2000 to 2019: a population-based study on 80 million live births

  • Maternal-Fetal Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

In the United States (US), deaths during pregnancy and childbirth have increased over the past 2 decades compared to other high-income countries, and there have been reports that racial disparities in maternal mortality have widened. The study objective was to examine recent trends in maternal mortality in the US by race.

Methods

Our population-based cross-sectional study used data from the Centers for Disease Control and Prevention’s 2000–2019 “Birth Data” and “Mortality Multiple Cause” data files from the US to calculate maternal mortality during pregnancy, childbirth, and puerperium across race. Logistic regression models estimated the effects of race on the risk of maternal mortality and examined temporal changes in risk across race.

Results

A total of 21,241 women died during pregnancy and childbirth, with 65.5% caused by obstetrical complications and 34.5% by non-obstetrical causes. Black women, compared with White women, had greater risk of maternal mortality (OR 2.13, 95% CI 2.06–2.20), as did American Indian women (2.02, 1.83–2.24). Overall maternal mortality risk increased during the 20-year study period, with an annual increase of 2.4 and 4.7/100,000 among Black and American Indian women, respectively.

Conclusions

Between 2000 and 2019, maternal mortality in the US increased, overall and especially in American Indian and Black women. Targeted public health interventions to improve maternal health outcomes should become a priority.

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Data availability

Data is pubicly and freely available on-line through the Ceters for Disease control and Prevention.

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Funding

No funding was secured for this study. Mr. Huang was personally supported by a CIHR Canada Graduate Scholarship-Master’s.

Author information

Authors and Affiliations

  1. Division of Experimental Medicine, McGill University, Montreal, QC, Canada

    Ryan S. Huang

  2. Center for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, Montreal, QC, Canada

    Andrea R. Spence & Haim A. Abenhaim

  3. Department of Obstetrics & Gynecology, Jewish General Hospital, McGill University, 5790 Cote-Des Neiges, Pav. H 325, Montreal, QC, H3S 1Y9, Canada

    Haim A. Abenhaim

Authors
  1. Ryan S. Huang
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Contributions

RSH carried out the data analyses; interpreted the data; drafted the initial manuscript; and reviewed and revised the subsequent drafts of the manuscript. ARS contributed to the data analytic design; interpreted the data; and reviewed and revised the manuscript. HAA conceptualized the study; designed the study; supervised and designed the data analyses; and critically reviewed the manuscript for important intellectual content. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

Corresponding author

Correspondence to Haim A. Abenhaim.

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Conflict of interest

The authors report no conflict of interest. This study was solely based on publicly available data. The journal may review this data.

Research involving human participants

This study exclusively used data from an existing administrative database. This data was publicly available; hence, according to the Tri-Council Policy statement (2018), institutional review board approval was not required.

Informed consent

This study used publicly available data; hence, we did not personally obtain informed consent from study subjects.

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Huang, R.S., Spence, A.R. & Abenhaim, H.A. Racial disparities in national maternal mortality trends in the United States from 2000 to 2019: a population-based study on 80 million live births. Arch Gynecol Obstet 309, 1315–1322 (2024). https://doi.org/10.1007/s00404-023-06999-6

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