Historical and Recent Changes in Maternal Mortality Due to Hypertensive Disorders in the United States, 1979 to 2018

Author:

Ananth Cande V.123ORCID,Brandt Justin S.4ORCID,Hill Jennifer4ORCID,Graham Hillary L.1ORCID,Grover Sonal5,Schuster Meike6,Patrick Haylea S.4,Joseph K.S.78

Affiliation:

1. Division of Epidemiology and Biostatistics, Department of Obstetrics, Gynecology, and Reproductive Sciences (C.V.A., H.G.), Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ.

2. Department of Medicine, Cardiovascular Institute of New Jersey (C.V.A.), Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ.

3. Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, NJ (C.V.A.).

4. Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences (J.S.B., J.H., H.S.P.), Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ.

5. Division of General Obstetrics and Gynecology (S.G.), Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ.

6. Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Jefferson Abington Health, Abington, PA (M.S.).

7. School of Population and Public Health (K.S.J.), University of British Columbia, Vancouver, Canada.

8. Department of Obstetrics and Gynaecology (K.S.J.), University of British Columbia, Vancouver, Canada.

Abstract

We evaluated the contributions of maternal age, year of death (period), and year of birth (cohort) on trends in hypertension-related maternal deaths in the United States. We undertook a sequential time series analysis of 155 710 441 live births and 3287 hypertension-related maternal deaths in the United States, 1979 to 2018. Trends in pregnancy-related mortality rate (maternal mortality rate [MMR]) due to chronic hypertension, gestational hypertension, and preeclampsia/eclampsia, were examined. MMR was defined as death during pregnancy or within 42 days postpartum due to hypertension. Trends in overall and race-specific hypertension-related MMR based on age, period, and birth cohort were evaluated based on weighted Poisson models. Trends were also adjusted for secular changes in obesity rates and corrected for potential death misclassification. During the 40-year period, the overall hypertension-related MMR was 2.1 per 100 000 live births, with MMR being almost 4-fold higher among Black compared with White women (5.4 [n=1396] versus 1.4 [n=1747] per 100 000 live births). Advancing age was associated with a sharp increase in MMR at ≥15 years among Black women and at ≥25 years among White women. Birth cohort was also associated with increasing MMR. Preeclampsia/eclampsia-related MMR declined annually by 2.6% (95% CI, 2.2–2.9), but chronic hypertension–related MMR increased annually by 9.2% (95% CI, 7.9–10.6). The decline in MMR was attenuated when adjusted for increasing obesity rates. The temporal burden of hypertension-related MMR in the United States has increased substantially for chronic hypertension–associated MMR and decreased for preeclampsia/eclampsia-associated MMR. Nevertheless, deaths from hypertension continue to contribute substantially to maternal deaths.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Internal Medicine

Reference49 articles.

1. WHO UNICEF UNFPA World Bank Group and the United Nations Population Division. Maternal Mortality: Levels and Trends 2000 to 2017. 2019. Accessed 23 October 2020. https://www.who.int/reproductivehealth/publications/maternal-mortality-2000-2017/en/

2. Maternal mortality in the United States: changes in coding, publication, and data release, 2018.;Hoyert DL;Natl Vital Stat Rep,2020

3. Evaluation of the pregnancy status checkbox on the identification of maternal deaths.;Hoyert DL;Natl Vital Stat Rep,2020

4. The impact of the pregnancy checkbox and misclassification on maternal mortality trends in the united states, 1999–2017.;Rossen LM;Vital & health statistics. Series 3, Analytical and epidemiological studies. U.S. Dept. of Health and Human Services, Public Health Service, National Center for Health Statistics,2020

5. Maternal Mortality From Preeclampsia/Eclampsia

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