The Black-White disparity in pregnancy-related mortality from 5 conditions: differences in prevalence and case-fatality rates.
OBJECTIVE
We sought to determine whether differences in the prevalences of 5 specific pregnancy complications or differences in case fatality rates for those complications explained the disproportionate risk of pregnancy-related mortality for Black women compared with White women in the United States.


METHODS
We used national data sets to calculate prevalence and case-fatality rates among Black and White women for preeclampsia, eclampsia, abruptio placentae, placenta previa, and postpartum hemorrhage for the years 1988 to 1999.


RESULTS
Black women did not have significantly greater prevalence rates than White women. However, Black women with these conditions were 2 to 3 times more likely to die from them than were White women.


CONCLUSIONS
Higher pregnancy-related mortality among Black women from preeclampsia, eclampsia, abruptio placentae, placenta previa, and postpartum hemorrhage is largely attributable to higher case-fatality rates. Reductions in case-fatality rates may be made by defining more precisely the mechanisms that affect complication severity and risk of death, including complex interactions of biology and health services, and then applying this knowledge in designing interventions that improve pregnancy-related outcomes.
Tucker
Myra J
MJ
Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Ga 30341-3724, USA.
Berg
Cynthia J
CJ
Callaghan
William M
WM
Hsia
Jason
J
D001741:Black or African American / Q000706:statistics & numerical data*; D005260:Female; D006306:Health Surveys; D017052:Hospital Mortality; D006801:Humans; D008428:Maternal Mortality / Q000639:trends*; D009309:National Center for Health Statistics, U.S.; D007744:Obstetric Labor Complications / Q000208:ethnology* / Q000401:mortality*; D011247:Pregnancy; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data*