The study examines the impact of data collection changes, particularly the introduction of a 'pregnancy checkbox' on death certificates, on reported maternal death rates in the United States. Researchers from Brown University and Columbia University conducted the study using a difference-in-differences analysis, comparing states that implemented the checkbox with those that had not.
According to the findings, two-thirds of the rise in maternal deaths from 2000 to 2019 was attributed to the checkbox, adding 6.8 deaths per 100,000 live births annually. However, maternal mortality rates remained stable for much of the period before the COVID-19 pandemic.
A significant increase in adjusted maternal mortality rates was noted in 2021 during the pandemic, peaking at 18.9 deaths per 100,000 live births. This rise affected women across all age, racial, and ethnic groups, except those aged 15-19. By 2022, the rates returned to pre-pandemic levels.
Seth Flaxman, Senior Author and Associate Professor at the University of Oxford, commented, "At the height of the COVID-19 pandemic, pregnant women died at significantly higher rates than they did before the pandemic. But when we took a careful look at the two decades before the pandemic, we found remarkably little change: in 2019 and 2023, pregnant women died at roughly the same rates as they did a generation earlier."
The study also emphasizes demographic disparities, with non-Hispanic Black women experiencing maternal mortality rates consistently three to four times higher than non-Hispanic White women before the pandemic. Additionally, Native American or Alaska Native women faced the largest increase in mortality rates during the pandemic.
While maternal mortality saw fluctuations, fetal and infant mortality rates generally declined from 2000 to 2020. Infant mortality dropped from 6.9 to 5.4 deaths per 1,000 live births, with a slight increase from 2021 onwards.
Data for the study was sourced from the National Vital Statistics Service, managed by the Centers for Disease Control and Prevention. The study titled "Trends in Maternal, Fetal and Infant Mortality in the US, 2000-2023" is published in JAMA Pediatrics.