Home Medizin Studie berichtet über einen alarmierenden Anstieg der Müttersterblichkeitsraten in den USA

Studie berichtet über einen alarmierenden Anstieg der Müttersterblichkeitsraten in den USA

von NFI Redaktion

According to a new study by Northwestern Medicine, the maternal mortality rate in the United States is alarmingly on the rise. Contrary to the common hypothesis that maternal mortality in the US has primarily increased due to older individuals becoming pregnant, the study found that maternal mortality increased across all age groups. The largest relative increases were observed among individuals aged 25-29 and 30-34 years.

A commonly held hypothesis is that there are more pregnancy-related deaths because more people are having children later in life. So, we wanted to explore that question. However, we found that this is not the reason for the rise in maternal mortality. While advanced maternal age is a significant risk factor for maternal mortality, our findings underscore the need to determine what else is contributing to these rates increasing in recent years, especially among younger adults under 35. We are moving in the wrong direction.


Dr. Sadiya Khan, corresponding author, Magistral Professor of Cardiovascular Epidemiology and Associate Professor of Cardiology at Northwestern University Feinberg School of Medicine

Between 2014 and 2021, the average maternal age in the US has increased from 28.3 to 29.4 years, a known risk factor for maternal mortality. During the same period, the overall maternal mortality rate in the US nearly doubled, from 16.5 to 31.8, with the strongest increase from 18.9 to 31.8 between 2019 and 2021.

The study was published on March 18 in the American Journal of Preventive Medicine.

This is the first study to highlight that age is not a factor in the increasing maternal mortality rate in the US. So where do we go from here?

While this study did not examine specific causes of death, numerous previous research, many of which were published by Khan, have found that cardiovascular diseases (hypertensive disorders, heart failure, and stroke) are a significant cause of poor maternal health outcomes.

“Understanding what the causes of death are and how to prevent them is crucial, as maternal mortality is largely preventable,” said Khan. “While some states, like Illinois, have maternal mortality review committees, we also need better national infrastructure and surveillance programs to review and address the root causes of the maternal health crisis.”

The study includes only states with a pregnancy checkbox on death certificates

To ensure that pregnancy-related deaths are accurately captured in the US, the National Vital Statistics System added a checkbox on death certificates in 2003 to indicate whether the deceased person was pregnant or recently pregnant.

When this study began in 2014, seven states had not yet implemented the pregnancy checkbox. Therefore, the study authors excluded these seven states (Alabama, Colorado, Georgia, Louisiana, Michigan, Ohio, and West Virginia) to control for the checkbox.

“There was actually a lot of controversy around whether the observed increase is a true increase or an artifact of how we are now collecting data,” said Khan. “But when we looked at deaths only in states that had already introduced the checkbox and did it the exact same way, we saw an accelerated increase over the past three years. While there are limitations in data collection from death certificates, they remain our best source for tracking this public health crisis.”

The study did not examine racial disparities

The study authors used data from the Centers for Disease Control’s Wonder databases to examine all maternal mortality and live births of individuals aged 15 to 44 years. One aspect of maternal death not examined in this study –; but crucial for this discussion –; is the role that racial disparities play. Black individuals are three times more likely to die from pregnancy-related deaths than white individuals. Khan stated that future studies would need to delve deeper into this issue.

Source:

Journal Reference:

Hughes, ZH, et al. (2024) Changes in Age Distribution and Maternal Mortality in a Subset of the United States, 2014–2021. American Journal of Preventive Medicine. doi.org/10.1016/j.amepre.2024.02.011.

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