Maternal + Infant Mortality

Question 1

Maternal mortality is nearly linearly associated with:

Answer 1

illiteracy rate
education
poverty

Question 2

What factor correlates most with rates of maternal death?

Answer 2

skilled birth attendant

Question 3

Definition of maternal mortality:

Answer 3

Death occurring during pregnancy or w/in 6 wks of delivery

excluding accidents, or if pregnancy is incidental to cause of death

Question 4

maternal mortality ratio =

Answer 4

deaths/100,000 live births in one year

Question 5

Maternal mortality rate =

Answer 5

deaths / # women of reproductive age

Question 6

How does the US’s MMR compare to that of economically developed countries?

Answer 6

its much higher, which is way bad

Question 7

According to the prof, MMR reflects:

Answer 7

the overall effectiveness of a country’s healthcare system

Question 8

According to the CDC, ___% of all maternal deaths are preventable.

Answer 8

50

Question 9

6 Specific medical causes for maternal death:

Answer 9

1. HTN in pregnancy
2. Infection
3. Pulmonary embolism
4. Amniotic fluid embolism
5. Hemorrhage
6. Heart disease (bc more women w/ heart dz getting preggers)

Question 10

What changed the trend in MMR, starting around 1935?

Answer 10

in-hospital births

Question 11

What is the world-wide trend in MMR?

Answer 11

everyone else is declining, but N. America has increasing maternal mortality rates

Question 12

What are some “speculations” about the recent changes in MMR?

Answer 12

• -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

Question 13

What is the racial disparity associated with MMR?

Answer 13

Black:White = 4:1

independent of education + income

Question 14

What cause of maternal death have we had the most dramatic positive impact on?

Answer 14

hemorrhage, due to improved transfusion protocols

Question 15

What causes of maternal death are increasing in frequency?

Answer 15

cardiomyopathy, CVA, CV

Question 16

Maternal death related to cardiomyopathy is defined as:

Answer 16

cardiomyopathy deaths up to 1 yr after delivery

Question 17

What are 3 ways he suggested may improve MMR?

Answer 17

1. public + provider education
2. reduce patient errors
3. protocols for patient management/trx

Question 18

What outcomes are classified as SEVERE morbidity?

Answer 18

hysterectomy, transfusion, eclampsia

Question 19

What factor correlates with severe morbidity?

Answer 19

extremes of age

young counts for racial disparity!

Question 20

What is an “extremely preterm” infant?

Answer 20

born <28 weeks (you can expect some long-term effects)

Question 21

What factor is related to pre-term (extremely to late) births?

Answer 21

racial disparity

Question 22

~50% of preterm births are ____
30% are due to:
~20 are due to:

Answer 22

• idiopathic
• premature preterm rupture of membranes
• medically indicated (includes pre-eclampsia!)