The contribution of heart disease to pregnancy-related mortality according to the pregnancy mortality surveillance system

• Published in: Journal of perinatology Vol. 32; no. 3; pp. 163 - 169
• Main Authors: Burlingame, J, Horiuchi, B, Ohana, P, Onaka, A, Sauvage, L M
• Format: Journal Article
• Language: English
• Published: New York Nature Publishing Group US 01.03.2012; Nature Publishing Group
• Subjects: 631/443/494; 692/699/75; 692/700/478/174; Adolescent; Adult; Age groups; Autopsies; Autopsy; Cardiovascular disease; Cardiovascular diseases; Cause of Death; Coronary artery disease; Demographic aspects; Disease control; Fatalities; Female; Gynecology; Hawaii - epidemiology; Heart; Heart diseases; Heart Diseases - mortality; Hemorrhage; Homicide; Humans; Maternal Mortality; Medicine; Medicine & Public Health; Mental health; Middle Aged; Mortality; Mothers; Obstetrics; original-article; Patient outcomes; Pediatric Surgery; Pediatrics; Population Surveillance; Pregnancy; Pregnancy Complications, Cardiovascular - mortality; Public health; Sepsis; Suicide; Surveillance; United States - epidemiology; Womens health; Young Adult; Hawaii; United States; United States > US; Hawaii; death certificate; pregnancy-related mortality ratio
• ISSN: 0743-8346; 1476-5543
• DOI: 10.1038/jp.2011.74

Objective: The objective of this study was to demonstrate the increasing importance of heart disease as a cause of pregnancy-related mortality in Hawaii and the rest of the United States. Study Design: Hawaii's Department of Public Health identified all pregnancy-associated death certificates from 1991 to 2007. Hospital records and autopsy reports were reviewed to determine whether deaths were pregnancy-related. Result: From 1991 to 2007, Hawaii registered 156 deaths occurring within 1 year of pregnancy, which represented 4.2% of the total number of women who died in the same 17 to 46 years age group and 9.0% of the total number of women who died in the same 17 to 34 years age group. The pregnancy-related mortality ratio was 22.4 and the pregnancy-associated mortality ratio was 50. The leading cause of pregnancy-associated mortality was heart disease (20.5%) followed by cancer (18.6%) and suicide/homicide (12.2%). Pregnancy-related deaths ( n =70) were attributed to heart disease (45.7%) followed by sepsis (14.2%) and hemorrhage (12.9%). The new Hawaii death certificate beginning in 2006 increased the detection of both pregnancy-related and -associated deaths. Conclusion: Heart disease is the most common cause of pregnancy-related mortality in Hawaii, and with improved ascertainment, may be determined to be the most common cause of pregnancy-related mortality in the rest of the United States.