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TOPLINE
Pregnancy-related mortality in the United States increased substantially from 2018 to 2021 and then declined. Cardiovascular conditions, infection or sepsis, and hemorrhage represented the most common causes of pregnancy-related deaths from 2005 to 2024.
METHODOLOGY
- Researchers analyzed 14,310 pregnancy-related deaths identified using data from the Centers for Disease Control and Prevention Pregnancy Mortality Surveillance System in the United States from 2005 to 2024.
- Deaths were classified into nine underlying cause-of-death categories: hemorrhage, infection or sepsis, amniotic fluid embolism, hypertensive disorders of pregnancy, thrombotic pulmonary or other embolisms, cerebrovascular accidents, anesthesia complications, cardiovascular conditions (including cardiomyopathy), and other noncardiovascular medical conditions. In 2020, COVID-19 was added to infection or sepsis.
- Pregnancy-related mortality ratios were calculated as the number of pregnancy-related deaths per 100,000 live births and by cause of death and year, using birth data from the National Vital Statistics System.
TAKEAWAY
- Throughout the study period, cardiovascular conditions accounted for 24.3% of pregnancy-related deaths, infection or sepsis for 17.8%, other medical conditions for 12.2%, and hemorrhage for 11.5%. COVID represented 58.8% of deaths from infection or sepsis from 2020 to 2024. Cardiovascular conditions were the leading cause of death for 17 of the 20 years.
- The overall pregnancy-related mortality ratio showed an increase from 2018 to 2021 (annual percent change [APC], 20.11; P < .001) but then a decrease in the following years (APC, -17.91; P < .001), peaking at 33.17 deaths per 100,000 live births in 2021.
- Deaths from infection or sepsis increased from 2018 to 2021 but decreased in the following years.
- Deaths from hemorrhage demonstrated an increasing trend from 2017 to 2024 (APC, 6.84; P = .02).
IN PRACTICE
"These differences underscore the importance of sustained surveillance for changes in pregnancy-related mortality that may help align research, quality improvement initiatives, and public health efforts to prevent leading and emerging causes of pregnancy-related death," the authors wrote.
SOURCE
The study was led by Fanny Njie, MPH, of Tanaq Support Services, in Anchorage, Alaska. It was published online on August 7, 2026, in Obstetrics & Gynecology.
LIMITATIONS
Data were constrained by the completeness and accuracy of original records. Pregnancy relatedness could not be determined in data for injury deaths or for cancer-related deaths due to limited information about circumstances of death.
DISCLOSURES
No funding was reported in the study. The authors reported no conflicts of interest.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
