Translational Research
Pregnancy-Related Mortality in California
Pregnancy-related mortality in California has been increasing over the past several years. Between 1998 and 2003 pregnancy-related mortality increased 43% and is 3.5 times higher than the Healthy People 2010 target. Pregnancy-related mortality is an indicator of maternal health in general, and increasing maternal mortality suggests that serious maternal morbidity is also increasing.
In 2006 the Maternal, Child and Adolescent Health Program, California Department of Public Health and the California Maternal Quality Care Collaborative (CMQCC) formed the California Pregnancy-Related and Pregnancy-Associated Mortality Review (CA-PAMR) committee to analyze maternal deaths in California with a focus on identifying opportunities for improvement and systems change. This is the first ever California state-wide maternal mortality review. This project is assessing all women who died within a year of a live birth or fetal death, beginning with the 2002 cohort of births. The goal is to determine whether maternal death was pregnancy-related, the cause of death, and what factors (community, patient, health care facility, and health care professional) contributed to the death.
Because of the concern about the continuing disparity in mortality rates between African-American and other women, CA-PAMR is paying particular attention to deaths by African-American women and selecting a higher proportion of them for study than women of other race/ethnicities. Selected cases undergo full medical record review and cases are then reviewed by the CA-PAMR Advisory Committee. CA-PAMR results and recommendations will be implemented through the quality improvement efforts of CMQCC. The reviews will continue through other years and are an important tool for identifying priority quality improvement projects for CMQCC.
