ArticleInternational journal of MCH and AIDS2021
Trends and Social Inequalities in Maternal Mortality in the United States, 1969-2018.
Article in International journal of MCH and AIDS, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 59 papers, 2 of them syntheses that pooled it.
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Who cites it
59 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Association between socioeconomic disadvantage and severe maternal morbidity and mortality in high-income countries: a systematic review.Journal of epidemiology and community health · 2025Pooled it
- Association between migration and severe maternal outcomes in high-income countries: Systematic review and meta-analysis.PLoS medicine · 2023Pooled it
- Correlation between severe maternal morbidity and rates of living alone among mothers in the USA.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2026Article
- The Texas Abortion Ban and Maternal Mental Health.JAMA network open · 2026Article
- Objective prenatal sleep and adverse childhood experiences in a proof-of-concept observational mixed methods study.iScience · 2026Article
- Association between social and built environment characteristics and maternal mortality in 340 Latin America cities: an ecological study from the SALURBAL study.BMJ public health · 2026Article
- Spatial analysis of environmental and socioeconomic factors impacting maternal and infant health outcomes in North Carolina.Journal of environmental studies and sciences · 2026Article
- Applying human-centered design to identify needs and generate recommendations to inform an integrated maternal health demonstration model.Frontiers in public health · 2026Article
- Accelerating birth equity using collaborative systems mapping.Health research policy and systems · 2025Article
- The Association of Perceived Stress, Glucocorticoids Receptors, and Corticotropin-Releasing Hormone Gene Expression During Pregnancy.Biological research for nursing · 2025Article
- Evaluation of a remote blood pressure monitoring program during pregnancy: utilization and implementation outcomes.Pregnancy hypertension · 2025Observational
- Over-the-Counter Oral Contraceptive Use and Initiation of Contraception.JAMA network open · 2025Article
- Racial, ethnic, and neighborhood disparities in diagnosis of perinatal psychiatric illness.AJOG global reports · 2025Article
- Physicians' experiences screening for and addressing patients' social needs in prenatal healthcare.Pregnancy (Hoboken, N.J.) · 2025Article
- Centering Birthing Experiences of Women of Color: Protocol for a Qualitative Maternal Near Miss Study.JMIR research protocols · 2025Article
- Trends in global and regional incidence and prevalence of hypertensive disordersin pregnancy (1990-2021): an age-period-cohort analysis.Scientific reports · 2025Article
- Associations between individual and structural level discrimination and psychological and physiological stress indicators during pregnancy.npj women's health · 2025Article
- Pregnancy-Associated Mortality During the Pandemic: Disparities by Rurality.American journal of preventive medicine · 2025Article
- Health Disparities in the Management and Outcomes of Critically Ill Children and Neonates: A Scoping Review.Critical care clinics · 2024Article
- Risk of Death at 1 Year Following Postpartum Opioid Exposure.American journal of perinatology · 2024Article
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Abstract
backgroundDespite the previous long-term decline and a recent increase in maternal mortality, detailed social inequalities in maternal mortality in the United States (US) have not been analyzed. This study examines trends and inequalities in US maternal mortality by maternal race/ethnicity, socioeconomic status, nativity/immigrant status, marital status, area deprivation, urbanization level, and cause of death.
methodsNational vital statistics data from 1969 to 2018 were used to compute maternal mortality rates by sociodemographic factors. Mortality trends by deprivation level were analyzed by using census-based deprivation indices. Rate ratios and log-linear regression were used to model mortality trends and differentials.
resultsMaternal mortality declined by 68% between 1969 and 1998. However, there was a recent upturn in maternal mortality, with the rate increasing from 9.9 deaths/100,000 live births in 1999 to 17.4 in 2018. The large racial disparity persisted over time; Black women in 2018 had a 2.4 times higher risk of maternal mortality than White women. During 2013-2017, the rate varied from 7.0 for Chinese women to 42.0 for non-Hispanic Black women. Unmarried status, US-born status, lower education, and rural residence were associated with 50-114% higher maternal mortality risks. Mothers in the most-deprived areas had a 120% higher risk of mortality than those in the most-affluent areas; both absolute and relative disparities in mortality by deprivation level widened between 2002 and 2018. Hemorrhage, pregnancy-related hypertension, embolism, infection, and chronic conditions were the leading causes of maternal death, with 31% of the deaths attributable to indirect obstetric causes. CONCLUSIONS AND GLOBAL HEALTH IMPLICATIONS: Despite the steep long-term decline in US maternal mortality, substantial racial/ethnic, socioeconomic, and rural-urban disparities remain. Monitoring disparities according to underlying social determinants is key to reducing maternal mortality as they give rise to inequalities in social conditions and health-risk factors that lead to maternal morbidity and mortality.
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