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Fact Sheet

February 20, 2003
Contact: Laura Leathers
(770) 488–5131

Pregnancy-Related Mortality Surveillance -- United States, 1991-1999


  • A pregnancy-related death is one that occurs during pregnancy or within a year after the end of pregnancy and is caused by pregnancy complications. Most (60 percent) of pregnancy-related deaths occurred after a live birth.

  • A total of 525 pregnancy-related deaths occurred in 1999 (the latest year for which data were available).

  • During 1991 to 1999, 4,200 deaths were found to be pregnancy-related

  • During the study period, about 12 pregnancy-related deaths occurred for every 100,000 live births.

  • The Healthy People 2010 Objectives for the United States proposed reduction in maternal mortality as a priority area, urging a rate of no more than 3.3 deaths per 100,000 live births.

Racial Disparity

  • A major racial disparity has persisted for more than 60 years, with black women having three to four times the risk of pregnancy-related death that white women do. This striking difference in the pregnancy-related mortality ratio is the largest disparity in the area of maternal and child health.

  • During 1991 to 1999, black women had a pregnancy-related mortality ratio of 30.0 per 100,000 live births, compared with 8.1 for white women.

Maternal Age

  • The risk of pregnancy-related mortality increased substantially among women aged 35 and older.

  • Women aged 40 and older had nearly four times the risk of dying from a pregnancy-related cause as women aged 30-34 years and had twice the risk for women aged 35-39 years.

Prenatal Care

  • Sixty percent of all pregnancy-related deaths occurred after a live birth. Of the women who died after a live birth, those who received no prenatal care were three to four times more likely to die of pregnancy-related causes than women who received any prenatal care.

  • Regardless of when women started prenatal care, black women still had a three to four times greater risk of pregnancy-related deaths than white women.

  • The relationship between prenatal care indicators (i.e., components of prenatal care and number of visits) and pregnancy-related mortality is not clear.

Leading Causes of Death

  • The leading causes of pregnancy-related death were embolism (20 percent), hemorrhage (17 percent), and pregnancy-related hypertension (16 percent).

  • Although the proportion of deaths to these causes has declined in recent years, the proportion of deaths due to cardiomyopathy (disease of the heart muscle) and other medical conditions has increased. The percentage of deaths due to cardiomyopathy increased from 6 percent in 1991 to 9 percent in 1999; the percentage of deaths due to other medical conditions increased from 14 percent to 20 percent during this same time period.

  • The leading cause of death varied by pregnancy outcome. Embolism remained the leading cause of death after a live birth, while hemorrhage was the main cause of death after a stillbirth.

Study Background

"Pregnancy-Related Mortality Surveillance—United States, 1991-1999” appears in the February 21, 2003, issue of the Morbidity and Mortality Weekly Report, which is published CDC. The report is based on CDC's Pregnancy Mortality Surveillance System, which collects information on pregnancy-related deaths from state health departments, maternal mortality review committees, media reports, and individual health providers. CDC’s surveillance of pregnancy mortality began in 1987. The United States ranks 20th in maternal mortality among all nations, according to the most recent World Health Organization estimates. Maternal mortality in the United States declined dramatically throughout most of the 20th century, from about 850 maternal deaths for every 100,000 births in 1900 to 7.5 in 1982. Since then, no further decrease in maternal mortality has occurred.

For a full copy of this report, see

For more information about maternal and child health research and programs, see CDC’s reproductive health website at

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This page last updated February 25, 2003

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