Certain miscalculations might have led to overestimation of maternal mortality rate in federal data than the actual reality, a report published by the American Journal of Obstetrics and Gynecology said.
The study found that the federal data was based on pregnancy checkbox, a feature introduced by the National Center for Health Statistics to address undercounting of deaths that occurred because of a pregnancy complication. The checkbox identifies whether deceased women had been pregnant at the time of death, within 42 days of death, within 43 days to a year before death, not pregnant, or if this information is unknown.
“The pregnancy checkbox was introduced as a means to correct the underestimation of maternal mortality, but we’ve gone from a 30 percent underestimation to like a 300 percent increase in maternal mortality rate, which is a substantial overestimation,” said Dr. KS Joseph, lead author of the study.
The study conducted by researchers from the University of British Columbia in Canada and other institutions analyzed of mortality files recorded by the National Center for Health Statistics from 1999 to 2021.
The checkbox method claimed a 144 percent rise in maternal mortality in women aged 15-44. Maternal mortality rate was 9.65 of 100,000 live births between 1999 and 2002, and 23.6 of 100,000 live births between 2018 and 2021. However, according to the researchers’ alternative methods, the maternal death rate changed only from 10.2 deaths to 10.4 deaths per 100,000 live births in the same time periods.
Researchers argued that being pregnant at death doesn’t mean that pregnancy caused the death. NCHS guidelines considered death of any pregnant woman as “maternal death” on certificate, which led to increase in overestimation of deaths.
Additionally, the recent study found that the maternal mortality rate is stable and deaths due to obstetric complications have dropped too. “Obstetric complications as a cause of death have decreased over time. That is expected because we have improvements in medical care,” Joseph added.
However, researchers agreed that rate of maternal mortality has surged in the U.S. in recent years, especially during the pandemic period.
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