Call to improve maternal morbidity, mortality rates.(Obstetrics)

WASHINGTON -- Despite claims to the contrary, there is still more work to do to reduce maternal morbidity and mortality in the United States, Cynthia Berg, M.D., said at a meeting sponsored by the Jacobs Institute of Women's Health.

Throughout the 20th century, maternal mortality in the United States gradually went from 900 deaths per 100,00 live births to about 10, noted Dr. Berg, who is a medical epidemiologist at the Centers for Disease Control and Prevention, Atlanta. "But in the past 20 years, there hasn't been a meaningful drop."

As a result of this slowing in decline, "some people believe that the United States has reached an irreducible minimum," she continued. "However, I would say there are a few pieces of evidence that would refute this claim."

For one thing, there are large racial and ethnic disparities in the risk of pregnancy-related death. For example, "the risk for black women is four times that for non-Hispanic white women, and that is one of the largest gaps in reproductive health treatment in the United States," Dr. Berg said. "Hispanics, Asian/Pacific Islanders, and Asian women also have a 50%-70% higher rate of pregnancy-related mortality than non-Hispanic white women."

Disparities also appear if both race and birthplace are taken into account. Although Hispanic and Asian women born in the United States have mortality rates similar to native-born white women, Hispanic and Asian women born outside the United States have a much higher mortality risk, according to Dr. Berg.

Although maternal mortality is often the focus of research, maternal morbidity deserves more attention than it is getting, said Stacie Geller, Ph.D., director of the University of Illinois at Chicago National Center of Excellence in Women's Health. "Clearly, studying morbidity itself is important, but it also is another way to try to reduce maternal mortality."

One study by Dr. Berg and her associates found that 43% of women experience some form ...