US Maternal Mortality Rate Increased Across All Groups from 1999 to 2019

Across American Indian and Alaskan Native (AIAN); Asian, Native Hawaiian, or other Pacific Islander (AANHPI); Hispanic; Black; and White patients, the United States maternal mortality rates (MMRs) increased from 1999 to 2019. At a minimum, rates doubled within each racial and ethnic group.

The study, published in JAMA on July 3, 2023, used observational data from registration and census information across the US. Focusing on 1999–2019, the researchers included data from pregnant and recently pregnant individuals between 10 and 54 years old.

Looking at the median state MMRs, researchers revealed that, in 1999, the MMR for AIAN patients was 14.0 maternal deaths per 100,000 live births. That number increased drastically to 49.2 maternal deaths per 100,000 live births in 2019, a 3.5 times increase.

In each of the other ethnic groups, MMRs also increased, with variable severity. For example, in 1999, the MMR for AANHPI individuals was roughly 9.6 maternal deaths per 100,000 live births. By 2019, that number had more than doubled, reaching 20.9 maternal deaths per 100,000 live births.

Comparatively, rates among Hispanic patients jumped from 9.6 to 19.1 deaths per 100,000 live births across that same span. Meanwhile, the MMRs for White patients increased from 9.4 to 26.3 maternal deaths per 100,000 live births.

With the highest MMRs across all ethnic groups, the MMR for Black patients increased from 26.7 to 55.4 maternal deaths per 100,000 live births. Despite Black patients having the highest rate across all racial and ethnic groups, the increase across this time was most significant for the AIAN group.

Theoretically, medical advancements across the decade should have facilitated a decline in MMRs; however, maternal deaths continue to be a rising problem across the US. The JAMA publication emphasizes that the rates across each group are unacceptable and need to be reduced. A significant emphasis should be placed on understanding the risks for AIAN and Black patients.

Although many sources theorize the reasons for these rising rates and discrepancies, more research is needed to evaluate and address these incidences.

In the meantime, the FDA’s recent approval of a blood test to assess the risk of pre-eclampsia, a leading cause of maternal mortality, may help minimize the risk of pre-eclampsia-related maternal deaths. The tool, developed by Thermo Fisher Scientific Inc, was approved on May 19, 2023, to test for blood-based biomarkers of pre-eclampsia in pregnant people.

“FDA clearance and availability of these novel biomarker tests throughout the country will allow caregivers to better manage and potentially improve outcomes for both mothers and their newborns,” said Ravi Thadhani, MD, MPH, executive vice president of health affairs at Emory University and co-author of the PRAECIS study, in the Thermo Fisher press release announcing the approval.