Black women lead maternal death rate in first CDC report in 13 years

The maternal death rate for 2018 was 17.4 deaths per 100,000 live births, and much higher among black women than other ethnicities, according to the first report on national maternal mortality the CDC has released since 2007. But this estimate may be a conservative figure, a prominent health expert said.

The CDC has not released new data on maternal mortality in over a decade because a new coding method was being implemented. The new method involves the use of a pregnancy status checkbox item on the U.S. Standard Certificate of Death. As of 2018, the checkbox was added to death certificates in all 50 states, allowing the CDC's National Center for Health Statistics to begin gathering and publishing maternal mortality data again.

The new data shows a total of 658 deaths were identified in 2018 as maternal deaths. It also found that the maternal death rate for non-Hispanic black women was 2.5 to 3.1 times the rates of non-Hispanic white and Hispanic women.

Maternal death rates also increased with age.

But the estimates the CDC reported may be conservative. Neel Shah, MD, an assistant professor of obstetrics, gynecology and reproductive biology at Harvard Medical School in Boston, tweeted that "placing a 'pregnancy' check box on the death certificate was a step forward ... but in many cases this box was being checked in error and muddying the picture."

The CDC has tried to address this issue "using a number of wonky exclusions. This yielded a more conservative estimate of the number of pregnancy-related deaths in our country," he tweeted.

The CDC's maternal mortality data does not account for suicide or homicide.

"It is very possible that the new CDC estimates are undercounting the ways in which mothers in [this] country are vulnerable to dying of preventable causes," Dr. Shah tweeted.

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