Maternal + Infant Mortality Flashcards
Maternal mortality is nearly linearly associated with:
illiteracy rate
education
poverty
What factor correlates most with rates of maternal death?
skilled birth attendant
Definition of maternal mortality:
Death occurring during pregnancy or w/in 6 wks of delivery
excluding accidents, or if pregnancy is incidental to cause of death
maternal mortality ratio =
deaths/100,000 live births in one year
Maternal mortality rate =
deaths / # women of reproductive age
How does the US’s MMR compare to that of economically developed countries?
its much higher, which is way bad
According to the prof, MMR reflects:
the overall effectiveness of a country’s healthcare system
According to the CDC, ___% of all maternal deaths are preventable.
50
6 Specific medical causes for maternal death:
- HTN in pregnancy
- Infection
- Pulmonary embolism
- Amniotic fluid embolism
- Hemorrhage
- Heart disease (bc more women w/ heart dz getting preggers)
What changed the trend in MMR, starting around 1935?
in-hospital births
What is the world-wide trend in MMR?
everyone else is declining, but N. America has increasing maternal mortality rates
What are some “speculations” about the recent changes in MMR?
- -Increased obesity
- -High unintended preg rates (partially due to oral pills)
- -Domestic abuse rates are high in the US
He was critical of these causes:
Increased immigration
Increased C/S rates
IVF – twins
What is the racial disparity associated with MMR?
Black:White = 4:1
independent of education + income
What cause of maternal death have we had the most dramatic positive impact on?
hemorrhage, due to improved transfusion protocols
What causes of maternal death are increasing in frequency?
cardiomyopathy, CVA, CV
Maternal death related to cardiomyopathy is defined as:
cardiomyopathy deaths up to 1 yr after delivery
What are 3 ways he suggested may improve MMR?
- public + provider education
- reduce patient errors
- protocols for patient management/trx
What outcomes are classified as SEVERE morbidity?
hysterectomy, transfusion, eclampsia
What factor correlates with severe morbidity?
extremes of age
young counts for racial disparity!
What is an “extremely preterm” infant?
born <28 weeks (you can expect some long-term effects)
What factor is related to pre-term (extremely to late) births?
racial disparity
~50% of preterm births are ____
30% are due to:
~20 are due to:
- idiopathic
- premature preterm rupture of membranes
- medically indicated (includes pre-eclampsia!)
