A data duel over U.S. maternal mortality

Experts agree that the U.S. maternal mortality rate is unacceptably high. And year after year of data show that disadvantaged groups, particularly Black and Native American women, die at even higher rates than women in the United States overall during pregnancy and childbirth. But controversy broke out last week over just how bad the situation is, when a paper by academic epidemiologists published in the American Journal of Obstetrics and Gynecology ( AJOG ) provoked unusual pushback from the U.S. Centers for Disease Control and Prevention (CDC). The paper suggested a widely reported tripling in the U.S. maternal mortality rate (MMR) over the past 2 decades was in fact largely due to a CDC-led recording change on death certificates, the addition of a “pregnancy checkbox.” That change was introduced to correct for previous underreporting of maternal deaths by as much as 50%. But the authors concluded this has led to the misclassification of many deaths as due to pregnancy when they were in fact incidental to it. These researchers instead ignored the pregnancy checkbox, counting as deaths only those with an explicit, pregnancy-related cause listed on the death certificate. Their analysis found that the maternal mortality rate hasn’t changed in 2 decades. It was an explosive finding that generated lots of headlines and within 2 days, the agency shot back with a statement contesting the findings. The authors’ methods, CDC wrote, “ar...
Source: ScienceNOW - Category: Science Source Type: news