title: Comparing Two Review Processes for Determination of Preventability of Maternal Mortality in Illinois.
abstract: OBJECTIVE
  To compare the results of two maternal death review processes conducted from 2002 to 2012 by Illinois regionalized perinatal centers with those conducted by the Illinois Department of Public Health's (IDPH's) statewide multidisciplinary external Maternal Mortality Review Committee (MMRC).
  
  
  METHODS
  This is a retrospective record review linking MMRC case assessment forms to the IDPH's Maternal Mortality Review Form database to compare causes of death and potential preventability as determined by both review processes.
  
  
  RESULTS
  MMRC records for 76 maternal death reviews were linked to the IDPH maternal mortality review form database. Most deaths reviewed by the statewide MMRC were due to pregnancy-related causes. The statewide MMRC differed from the regional perinatal centers on cause of death in 55.3% (n = 42) of cases and on the disposition of potential preventability in 48.7% (n = 37) of cases. The statewide MMRC judged 69.7% (n = 53) of cases potentially preventable, compared with 40.8% (n = 31) for the regional perinatal centers. The MMRC identified more preventable provider and systems factors for potentially preventable deaths compared with regional perinatal centers which identified more preventable patient factors.
  
  
  CONCLUSIONS
  The statewide MMRC found more potential preventability and determined that preventability was associated with provider and systems factors, not patient factors. Observed discrepancies between regional perinatal center and statewide MMRC reviews were likely due to the complexity of cases selected for review, the multidisciplinary external composition of the review team, and the de-identification of cases. Multidisciplinary statewide expert panels should be implemented in addition to local and regionalized reviews.
authors.affiliation: Department of Obstetrics and Gynecology, Center for Research on Women and Gender, College of Medicine, University of Illinois at Chicago, 820 S. Wood St., Chicago, IL, 60612, USA. sgeller@uic.edu.
authors.forename: Stacie E
authors.initials: SE
authors.lastname: Geller
authors.affiliation: Center for Research on Women and Gender, University of Illinois at Chicago, Chicago, IL, USA.
authors.forename: Abigail R
authors.initials: AR
authors.lastname: Koch
authors.affiliation: Perinatal Health Data Section, Center for Health Statistics, Illinois Department of Public Health, Chicago, IL, USA.
authors.forename: Nancy J
authors.initials: NJ
authors.lastname: Martin
authors.affiliation: Rush University, Chicago, IL, USA.
authors.forename: Patricia
authors.initials: P
authors.lastname: Prentice
authors.affiliation: Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, Chicago, IL, USA.
authors.forename: Deborah
authors.initials: D
authors.lastname: Rosenberg
mesh_terms: D000293:Adolescent; D000328:Adult; D002423:Cause of Death / Q000639:trends*; D005260:Female; D006801:Humans; D007087:Illinois / Q000453:epidemiology; D008428:Maternal Mortality / Q000639:trends*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000401:mortality* / Q000517:prevention & control; D012189:Retrospective Studies
keywords: Maternal mortality review; Pregnancy-related mortality; State-based mortality review