Better Data Collection Needed to Reduce Maternal Mortality.

The rising maternal mortality rates in Texas indicate a need to improve maternal health-related data collection, according to a new study co-authored by a School of Public Health researcher.

The study, published in Birth, found a sharp increase in maternal mortality rates in Texas. The researchers attributed some of the rate increase to overreporting and a flawed data collection system.

“Both the increasing maternal mortality rates in Texas and the substantial data problems identified in our study constitute an urgent call for action,” said lead author Marian MacDorman, research professor at Maryland Population Research Center. “While the dramatic increase in maternal deaths in Texas is most concerning, this is a problem that needs to be addressed nationwide.”

Maternal mortality has long been considered a primary indicator of the quality of health care both in the United States and internationally. In 1990, the United Nations named maternal mortality reduction as a Millennium Development Goal, leading to an unprecedented effort to reduce maternal mortality worldwide. Globally, maternal mortality decreased by 44 percent from 1990 to 2015, including a 48 percent decline among developed regions. However, the United States maternal mortality rate has shown consistent increases. Prior research by MacDorman and colleagues showed that the US maternal death rate increased 27 percent overall between 2000 and 2014, while rates declined internationally.

The researchers used the National Vital Statistics System to obtain maternal mortality statistics for subnational and national comparisons and grouped the mortality rate into five-year averages from 2006 to 2010 and 2011 to 2015. They found an 87 percent increase in maternal deaths in Texas when comparing data from 2011 to 2015 with 2006 to 2010.

In a commentary accompanying the Birth article, the authors argued for a “systemic evaluation” of current reporting methods for maternal deaths, as well as the implementation of validation studies, data quality checks, and enhanced education and training at state and national levels.

“Maternal mortality is the tip of the iceberg regarding the poor performance of the United States in women’s health. It is critical that we first establish better data systems to document the problem and then develop systems that focus on women’s health, not just when they’re pregnant, but throughout the life-course.” said Eugene Declercq, co-author and professor of community health sciences, summarizing their research.

The study was co-authored by Marie Thoma, assistant professor at University of Maryland School of Public Health.

—Salma Abdalla