The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #61698

Andrea P. MacKay, MSPH¹, Cynthia Berg, MD², Catherine Duran¹, Jeani Chang, MPH³, and Harry M. Rosenberg, Dr⁴. (1) National Center for Health Statistics (NCHS), Centers for Disease Control and Prevention (CDC), 3311 Toledo Rd., Rm 6121, Hyattsville, MD 20782, 301 458-4358, anm3@cdc.gov, (2) Division of Reproductive Health, Centers for Disease Control and Prevention, 1600 Clifton Rd., Atlanta, GA 30333, (3) Division of Reproductive Health, Centers for Disease Control and Prevention (CDC), Koger/Columbia Building, 2900 Woodcock Blvd, Atlanta, GA 30341, (4) National Center for Health Statistics (Retired), Centers for Disease Control and Prevention, 7008 Richard Drive, Bethesda, MD 20817

Deaths from pregnancy complications remain an important public health concern. Nationally, two systems collect information on the number of deaths and characteristics of the women who died: CDC’s National Center for Health Statistics reports maternal mortality through the National Vital Statistics System (NVSS); CDC’s Division of Reproductive Health’s Pregnancy Mortality Surveillance System (PMSS) conducts epidemiologic surveillance of pregnancy-related deaths. The number of deaths reported by these two systems have shown a continuing disparity. Our objective was to determine the magnitude and nature of the differences in the two systems. For 1995-1997, we compared maternal deaths in NVSS with pregnancy-related deaths in PMSS for the 50 States, DC, and NYC, using ICD-9 codes. PMSS deaths coded 630-676 were considered maternal deaths in NVSS while PMSS deaths coded other than 630-676 were not. There were 1383 pregnancy-related deaths (PMSS) and 898 maternal deaths (NVSS); 52% of these deaths were reported in both systems, 40% in PMSS only, and 8% in NVSS only. Deaths from hemorrhage, embolism, pregnancy-induced hypertension, and anesthesia complications were more likely to be identified as maternal deaths by NVSS than deaths from cardiovascular complications, medical conditions or infection. Based on the deaths classified as either maternal or pregnancy-related, minus those identified as being outside the temporal boundaries, we estimate an overall maternal mortality ratio of 12.7/100,000 live births for the three-year study period, compared to 11.8 for PMSS and 7.7 for NVSS. Combining the resources of NVSS and PMSS provides an enhanced assessment of maternal mortality in the U.S.

Learning Objectives:

• • Describe the differences between the National Vital Statistics System and the Pregnancy Mortality Surveillance System, and how each collects information and classifies deaths related to pregnancy.
  • Assess the disparities in maternal mortality ratios between the two systems.
  • Evaluate the importance of supplemental information in identifying maternal deaths.

Keywords: Mortality, Epidemiology

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.