Pregnancy-related maternal deaths in NYC were twice as high as the national average, the NYC Department of Health said in a report released today. And the U.S. maternal morality ratio has not decreased for twenty years.
The report was based on a study between 2001 and 2005 of the 161 NYC women whose deaths, within a year of pregnancy, were "caused or exacerbated by pregnancy."
During that time, NYC's maternal mortality ratio -- the number of maternal deaths per 100,000 pregnancies -- was 23.1 while the national rate was 11.8.
According to the NYC report, 49% of the studied women were classified as obese and 56% had a chronic health condition such as asthma or hypertension. Further, black women were seven times more likely than white women to die from pregnancy-related causes.
In an assessment of the specific causes of death, the Department of Health found that 60% of the studied women's deaths were directly attributed to the pregnancy. Of these, two thirds were due to embolism, hemorrhage, infection, and pregnancy-related hypertension.
In the rest of the cases, where death occurred within a year of pregnancy but was not directly attributed to the pregnancy, half of these were due to injury. "Homicide accounted for 44% of these injury deaths. More than half of the homicide deaths were linked to intimate-partner violence."
“Maternal mortality is a leading indicator of women’s health and the health of communities,” New York City Health Commissioner Dr. Thomas Farley, said in the Health Department press release. “It is far less common than it once was, but it is a devastating experience for any family."
The U.S. maternal mortality ratio, which is a measure of the maternal deaths per 100,000 births, was 35th among other World Health Organization (WHO) members in 2005.
For this report, between 2001 and 2005 the Department of Health monitored maternal deaths with "enhanced surveillance," meaning it examined all maternal deaths within a year of birth instead of a subset of deaths occurring up to 42 days after birth. Most other health organizations, including the federal U.S. government and the WHO, conduct "standard surveillance" research using the latter criteria.
However, the "23.1 maternity mortality ratio" statistic was calculated using standard surveillance so that it would be comparable to the U.S. at large. Thirty-six of the 161 women in the study would not have been counted under pregnancy-related deaths according to national standards. The rest of the report's statistics come from an enhanced surveillance analysis.
Pointing out that Healthy People 2010's health objectives for the U.S. include a target 4.3 maternal mortality ratio, the report calls for "an integrated, multi-component approach that that involves women, communities, providers, maternity facilities, and policy makers" with the goal of eventually reducing maternal mortalities.
"Clearly, there are areas that we need to pay attention to because the rates have not gone down," said Judy Sackoff of the Health Department's Maternal, Infant and Reproductive Health bureau.
The Health Department held a meeting entitled "Call to Action" today to "pull in the larger community and set the agenda for what has to happen next," Sackoff told NBCNewYork. These included the New York Academy of Medicine and city and state representatives.
"There's no one group that can possibly take this on. Everybody has a piece in designing what's the next step," she said.
The full text of the report can be found here.