The Need for National Pregnancy Mortality Surveillance

Reliable, accurate information is a prerequisite to achieving further reductions in maternal mortality in the US and determining the risk factors for maternal death. In 1988, the Centers for Disease Control (CDC) began a national pregnancy mortality surveillance to detect all pregnancy-related deaths. The CDC will conduct case investigations, compile data from both national and state vital statistic reporting systems, and utilize investigative approaches that have been successful in identifying misclassified maternal deaths. It is expected that the number of deaths identified through the CDC system will be greater than that reported by the vital statistics systems alone. Moreover, vital statistics systems do not provide data sufficiently detailed (beyond only race and cause of death) for epidemiological analysis. The success of CDC's abortion surveillance system has been largely due to its use of multiple sources of reporting and information. For example, of 538 possible abortion-related deaths identified by CDC in 1972-82, only 69% were obtained from national statistics and state health department reports; the remainder came from individuals and other sources such as published case histories and medical and hospital committees. State vital statistics are believed to understate maternal deaths by 17-73%.