Maternal mortality and related concepts.
OBJECTIVE
This report presents data on U.S. deaths to pregnant or recently pregnant women, summarizes long-term processing issues, and examines recent changes affecting the data and the impact of the changes on the statistics for these women.


METHODS
This report presents descriptive tabulations of information reported on death certificates that are completed by funeral directors, attending physicians, medical examiners, and coroners. The original records are filed in the state registration offices. Statistical information is compiled into a national database through the Vital Statistics Cooperative Program of the Centers for Disease Control and Prevention's (CDC) National Center for Health Statistics (NCHS). Causes of death are processed in accordance with the International Classification of Diseases (ICD).


RESULTS
Maternal mortality fluctuates from year to year but was 12.1 deaths per 100,000 live births in 2003. The implementation of the International Classification of Diseases, Tenth Revision (ICD-10) in 1999 resulted in about a 13 percent increase in the number of deaths identified as maternal deaths between 1998 and 1999. The rate increased again between 2002 and 2003 after a separate pregnancy question became a standard item on the U.S. Standard Certificate of Death. The adoption of a standard separate question on pregnancy facilitates the identification of late maternal deaths.


CONCLUSIONS
Maternal deaths increased with the introduction of the ICD-10 and with changes associated with the addition of a separate pregnancy status question on the U.S. Standard Certificate of Death. These changes may result in better identification of maternal deaths.
Hoyert
Donna L
DL
Division of Vital Statistics. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics, Hyattsville, Maryland 20782, USA.
D002423:Cause of Death / Q000639:trends*; D002487:Centers for Disease Control and Prevention, U.S.; D003334:Coroners and Medical Examiners; D016208:Databases, Factual; D003644:Death Certificates; D005260:Female; D006801:Humans; D038801:International Classification of Diseases; D008428:Maternal Mortality / Q000639:trends*; D011159:Population Surveillance; D011247:Pregnancy; D040442:Public Health Informatics; D013219:State Government; D014481:United States / Q000453:epidemiology; D014798:Vital Statistics