Hospital-based maternal deaths are occurring earlier in pregnancy or postpartum, while maternal deaths occurring at the time of delivery are declining in the United States, research suggests.

Hospitalizations that occur in the antenatal period—or during pregnancy, but before giving birth—and those that occur in the postpartum period, made up over half of in-hospital maternal deaths between 2017-2019, the new study reveals.

The findings, published in JAMA Network Open, estimate rates of in-hospital maternal deaths from the National Inpatient Sample from the years 1994 to 2015 and from 2017 to 2019 among antenatal, childbirth, and postpartum hospitalizations in the United States.

“Maternal mortality rates are high in the United States, higher than as seen in all other industrialized countries,” says lead author Lindsay Admon, an assistant professor of obstetrics and gynecology at the University of Michigan Medical School and obstetrician-gynecologist at University of Michigan Von Voigtlander Women’s Hospital.

“Maternal mortality continues to increase in the US, and we wanted to understand trends in hospital-based deaths: Are they happening during pregnancy, at birth, or postpartum? Has this changed over time? Basically, we wanted to generate data that could help design clinical and policy interventions for preventing the most adverse of all obstetric outcomes in the hospital setting, maternal death.

In their recent study, Admon and coauthors found that over the 20-year period between 1994-1995 and 2014-2015, in-hospital maternal deaths occurring at the time of childbirth declined by more than half (56%). During the same period, rates of in-hospital maternal death occurring during the antenatal and postpartum periods remained unchanged.

In looking at the most recent data from 2017 to 2019, the research team found that hospitalizations for childbirth accounted for nearly 90% of hospitalizations occurring during pregnancy through a few weeks after childbirth—but for only half of in-hospital maternal deaths.

In contrast, antenatal and postpartum hospitalizations accounted for less than 10% of all hospitalizations occurring during pregnancy through a few weeks after childbirth, but half of the in-hospital maternal deaths identified.

Read the full article about maternal deaths in hospitals at Futurity.