A Review of Pregnancy-Related Maternal Mortality in Wisconsin, 2006-2010.

INTRODUCTION Maternal mortality is a key indicator of maternal health and the general state of health care. This report summarizes maternal deaths in Wisconsin from January 2006 through December 2010. METHODS Maternal deaths were identified using death certificates and supporting links with infant birth and fetal death certificates. Suspected pregnancy-related maternal deaths were abstracted by a Wisconsin Maternal Mortality Review Team nurse abstractor. The entire team reviewed and analyzed these cases. If the death was deemed pregnancy related, a cause of death was determined, potential factors of avoidability were assessed, and recommendations for possible quality improvement were made. RESULTS Fifty cases were reviewed and 21 cases were determined to be pregnancy related. The Wisconsin pregnancy-related maternal mortality ratio was 5.9 deaths per 100,000 live births (3.9-9.0, 95% CI), with markedly higher rates for non-Hispanic black women. The most common cause of death was cardiovascular related, with 5 of the 7 deaths being ascribed to peripartum cardiomyopathy. Chronic medical problems were associated with 55% of pregnancy-related maternal deaths excluding obesity. Nineteen percent of the pregnancy-related deaths reviewed were considered to be avoidable, and almost half (48%) had substantive recommendations made to improve maternal health. CONCLUSION Even though the Wisconsin pregnancy-related maternal mortality ratio is well below the national average, there remain stark racial disparities in maternal deaths and a number of avoidable pregnancy-related deaths that should be targeted for prevention.