Skip to main content

Maternal Deaths in Developed Countries: Epidemiology and Preventable Causes

  • Chapter
  • First Online:
Principles and Practice of Maternal Critical Care

Abstract

Patterns of maternal mortality in the developed world changed dramatically over recent decades. Death from acute events such as obstetric hemorrhage decreased, while those from cardiovascular and non-cardiovascular medical complications increased. Addressing risk from chronic medical conditions that necessitate management throughout the continuum of pregnancy, delivery, and postpartum remains critical to reducing the global maternal mortality. In this chapter, we review the epidemiology of maternal mortality in developed countries, focusing on risk factors and temporal trends for maternal mortality rates, followed by an overview of the preventability of death from the ten leading causes of maternal mortality.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 169.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 249.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

References

  1. Creanga AA, Syverson C, Seed K, Callaghan WM. Pregnancy-related mortality in the United States, 2011–2013. Obstet Gynecol. 2017;130(2):366–73.

    Article  Google Scholar 

  2. Cantwell R, Clutton-Brock T, Cooper G, et al. Saving Mothers’ lives: reviewing maternal deaths to make motherhood safer: 2006–2008. The eighth report of the confidential enquiries into maternal deaths in the United Kingdom. BJOG. 2011;118(Suppl):1:1–203.

    Google Scholar 

  3. Khan KS, Wojdyla D, Say L, Gulmezoglu AM, Van Look PF. WHO analysis of causes of maternal death: a systematic review. Lancet. 2006;367:1066–74.

    Article  Google Scholar 

  4. Knight M, Nair M, Tuffnell D, Kenyon S, Shakespeare J, Brocklehurst P, Kurinczuk JJ, editors. On behalf of MBRRACE-UK. Saving lives, improving mothers’ care—surveillance of maternal deaths in the UK 2012–14 and lessons learned to inform maternity care from the UK and Ireland confidential enquiries into maternal deaths and morbidity 2009–14. Oxford: National Perinatal Epidemiology Unit, University of Oxford; 2016.

    Google Scholar 

  5. Knight M, Kenyon S, Brocklehurst P, Neilson J, Shakespeare J, Kurinczuk JJ, editors. On behalf of MBRRACE-UK. Saving lives, improving mothers’ care—lessons learned to inform future maternity care from the UK and Ireland confidential enquiries into maternal deaths and morbidity 2009–12. Oxford: National Perinatal Epidemiology Unit, University of Oxford; 2014.

    Google Scholar 

  6. Knight M, Nair M, Tuffnell D, Shakespeare J, Kenyon S, Kurinczuk JJ, editors. On behalf of MBRRACE-UK. Saving lives, improving mothers’ care—lessons learned to inform maternity care from the UK and Ireland confidential enquiries into maternal deaths and morbidity 2013–15. Oxford: National Perinatal Epidemiology Unit, University of Oxford; 2017.

    Google Scholar 

  7. Knight M, Tuffnell D, Kenyon S, Shakespeare J, Gray R, Kurinczuk JJ, editors. On behalf of MBRRACE-UK. Saving lives, improving mothers’ care—surveillance of maternal deaths in the UK 2011–13 and lessons learned to inform maternity care from the UK and Ireland confidential enquiries into maternal deaths and morbidity 2009–13. Oxford: National Perinatal Epidemiology Unit, University of Oxford; 2015.

    Google Scholar 

  8. Creanga AA, Berg CJ, Syverson C, Seed K, Bruce FC, Callaghan WM. Pregnancy-related mortality in the United States, 2006–2010. Obstet Gynecol. 2015;125:5–12.

    Article  Google Scholar 

  9. Clark SL, Belfort MA, Dildy GA, Herbst MA, Meyers JA, Hankins GD. Maternal death in the 21st century: causes, prevention, and relationship to cesarean delivery. Am J Obstet Gynecol. 2008;199:36.e1–5. discussion 91–2 e7–11.

    Article  Google Scholar 

  10. Clark SL, Christmas JT, Frye DR, Meyers JA, Perlin JB. Maternal mortality in the United States: predictability and the impact of protocols on fatal postcesarean pulmonary embolism and hypertension-related intracranial hemorrhage. Am J Obstet Gynecol. 2014;211:32.e1–9.

    Article  Google Scholar 

  11. Saucedo M, Deneux-Tharaux C, Bouvier-Colle MH, French National Experts Committee on Maternal M. Ten years of confidential inquiries into maternal deaths in France, 1998–2007. Obstet Gynecol. 2013;122:752–60.

    Article  Google Scholar 

  12. Schutte JM, Steegers EA, Schuitemaker NW, et al. Rise in maternal mortality in the Netherlands. BJOG. 2010;117:399–406.

    Article  CAS  Google Scholar 

  13. Australian Institue of Health and Welfare. Maternal deaths in Australia 2012–2014. 2017. https://www.aihw.gov.au/reports/mothers-babies/maternal-deaths-in-australia-2012-2014/contents/table-of-contents. Accessed Feb 2018.

  14. Health Quality and Safety Commission New Zealand. Eleventh annual report of the perinatal and maternal mortality review committee: reporting mortality 2015. Wellington: Health Quality & Safety Commission; 2017. https://www.hqsc.govt.nz/assets/PMMRC/Publications/2017_PMMRC_Eleventh_Annual_Report.pdf. Accessed Feb 2018.

    Google Scholar 

  15. Alkema L, Chou D, Hogan D, et al. Global, regional, and national levels and trends in maternal mortality between 1990 and 2015, with scenario-based projections to 2030: a systematic analysis by the UN Maternal Mortality Estimation Inter-Agency Group. Lancet. 2016;387:462–74.

    Article  Google Scholar 

  16. Hogan MC, Foreman KJ, Naghavi M, et al. Maternal mortality for 181 countries, 1980–2008: a systematic analysis of progress towards Millennium Development Goal 5. Lancet. 2010;375:1609–23.

    Article  Google Scholar 

  17. Bodker B, Hvidman L, Weber T, et al. Maternal deaths in Denmark 2002–2006. Acta Obstet Gynecol Scand. 2009;88:556–62.

    Article  Google Scholar 

  18. Centers for Disease Control and Prevention. Pregnancy mortality surveillance system. www.cdc.gov/reproductivehealth/maternalinfanthealth/pmss.html. Accessed 4 Mar 2020.

  19. Centers for Disease Control and Prevention. Maternal mortality. https://www.cdc.gov/nchs/maternal-mortality/index.htm. Accessed 5 Mar 2020.

  20. Callaghan WM. Overview of maternal mortality in the United States. Semin Perinatol. 2012;36:2–6.

    Article  Google Scholar 

  21. Philibert M, Deneux-Tharaux C, Bouvier-Colle MH. Can excess maternal mortality among women of foreign nationality be explained by suboptimal obstetric care? BJOG. 2008;115:1411–8.

    Article  CAS  Google Scholar 

  22. Knight M, Bunch K, Kenyon S, Tuffnell D, Kurinczuk JJ. A national population-based cohort study to investigate inequalities in maternal mortality in the United Kingdom, 2009–17. Paediatr Perinat Epidemiol. 2020. https://doi.org/10.1111/ppe.12640.

  23. Berg CJ, Atrash HK, Koonin LM, Tucker M. Pregnancy-related mortality in the United States, 1987–1990. Obstet Gynecol. 1996;88:161–7.

    Article  CAS  Google Scholar 

  24. Palmerola KL, D’Alton ME, Brock CO, Friedman AM. A comparison of recommendations for pharmacologic thromboembolism prophylaxis after caesarean delivery from three major guidelines. BJOG. 2016;123:2157–62.

    Article  CAS  Google Scholar 

  25. Sibai BM, Rouse DJ. In reply. Obstet Gynecol. 2017;129:382–3.

    Article  Google Scholar 

  26. The Royal College of Obstetricians and Gynaecologists. Thrombosis and embolism during pregnancy and the puerperium, reducing the risk. Green-top guideline no. 37a, vol. 2015. London: The Royal College of Obstetricians and Gynaecologists; 2015.

    Google Scholar 

  27. California Maternal Quality Care Collaborative. California pregnancy-associated mortality review 1999–2013. https://www.cmqcc.org/research/ca-pamr-maternal-mortality-review. Accessed Feb 2018.

  28. Berg CJ, Harper MA, Atkinson SM, et al. Preventability of pregnancy-related deaths: results of a state-wide review. Obstet Gynecol. 2005;106:1228–34.

    Article  Google Scholar 

  29. The New York State Department of Health. New York state maternal mortality review report 2012–2013. 2017. https://www.health.ny.gov/community/adults/women/docs/maternal_mortality_review_2012-2013.pdf.

  30. The California Pregnancy-Associated Mortality Review. Report from 2002 and 2003 maternal death reviews. Sacramento: California Department of Public Health, Maternal Child and Adolescent Health Division; 2011.

    Google Scholar 

  31. Shields LE, Wiesner S, Klein C, Pelletreau B, Hedriana HL. Use of maternal early warning trigger tool reduces maternal morbidity. Am J Obstet Gynecol. 2016;214:527 e1–6.

    Article  Google Scholar 

  32. The Royal College of Obstetricians and Gynaecologists. Thrombosis and embolism during pregnancy and the puerperium, reducing the risk. Green-top guideline no. 37a. London: The Royal College of Obstetricians and Gynaecologists; 2009.

    Google Scholar 

  33. Clark SL, Romero R, Dildy GA, et al. Proposed diagnostic criteria for the case definition of amniotic fluid embolism in research studies. Am J Obstet Gynecol. 2016;215:408–12.

    Article  Google Scholar 

  34. Beckett VA, Knight M, Sharpe P. The CAPS study: incidence, management and outcomes of cardiac arrest in pregnancy in the UK: a prospective, descriptive study. BJOG. 2017;124:1374–81.

    Article  CAS  Google Scholar 

  35. Main EK, Goffman D, Scavone BM, et al. National Partnership for maternal safety: consensus bundle on obstetric hemorrhage. Obstet Gynecol. 2015;126:155–62.

    Article  Google Scholar 

  36. D’Alton ME, Friedman AM, Smiley RM, et al. National partnership for maternal safety: consensus bundle on venous thromboembolism. Obstet Gynecol. 2016;128:688–98.

    Article  Google Scholar 

  37. D’Alton ME, Bonanno CA, Berkowitz RL, et al. Putting the “M” back in maternal-fetal medicine. Am J Obstet Gynecol. 2013;208:442–8.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Cande V. Ananth .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Friedman, A.M., Ananth, C.V. (2020). Maternal Deaths in Developed Countries: Epidemiology and Preventable Causes. In: Einav, S., Weiniger, C.F., Landau, R. (eds) Principles and Practice of Maternal Critical Care. Springer, Cham. https://doi.org/10.1007/978-3-030-43477-9_1

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-43477-9_1

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-43476-2

  • Online ISBN: 978-3-030-43477-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics