Disparities in mortality among high risk pregnant women in Illinois: a population based study.
OBJECTIVE
Researchers are increasingly studying maternal mortality in the context of maternal morbidity in order to identify risk and protective factors operating at each point along the morbidity-mortality continuum. This study examined factors associated with mortality in pregnant women with severe morbidity. In particular, the Black-White disparity was examined.


METHODS
Illinois vital records data were linked to identify maternal deaths and other pregnant women with severe morbidity. Pregnancy-related deaths and high risk survivors were compared and case fatality rates were computed. Condition-specific and multivariable analyses were conducted, and time of death was examined.


RESULTS
The overall risk of maternal death was 37.1 per 10,000 high risk pregnant women in Illinois from 1994 to 1998. Women who were older, African American, unmarried, or living in Chicago were at elevated risk of death. The adjusted relative risk for the Black-White disparity was 3.7 among all high risk pregnant women and 8.5 among women with hypertensive disorders. A greater proportion of African American and Hispanic women died within 7 days of delivery compared to White women.


CONCLUSIONS
Medical risk status alone cannot explain disparities in maternal mortality. The Black-White disparity for risk of death persisted in both overall and condition-specific analyses.
Rosenberg
Deborah
D
Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, 60612, USA. drose@uic.edu
Geller
Stacie E
SE
Studee
Laura
L
Cox
Suzanne M
SM
D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D002648:Child; D003644:Death Certificates; D005260:Female; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D007087:Illinois / Q000453:epidemiology; D008428:Maternal Mortality / Q000639:trends*; D011159:Population Surveillance; D011247:Pregnancy; D018566:Pregnancy, High-Risk; D012307:Risk Factors; D044465:White People / Q000706:statistics & numerical data*