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Failure to Rescue Drives Racial Disparity in Maternal Mortality

WEDNESDAY, April 28, 2021 -- Failure to rescue from severe maternal morbidity contributes to more than half of the threefold difference in maternal mortality between Black women and White women, according to a study published in the May issue of Obstetrics & Gynecology.

Jean Guglielminotti, M.D., Ph.D., from Columbia University in New York City, and colleagues used data from the National Inpatient Sample (1999 to 2017) to assess trends in racial and ethnic disparities in failure to rescue (i.e., death) associated with severe maternal morbidity.

The researchers identified 73,934,559 delivery hospitalizations during the study period, including 993,864 with severe maternal morbidity (13.4 per 1,000). Among women with severe maternal morbidity, 4.3 per 1,000 died, accounting for 88 percent of deaths during delivery. For Black women, in an adjusted analysis, the failure-to-rescue rate ratio was 1.79 versus 1.39 for women of other race and ethnicity, 1.43 for women with missing race and ethnicity data, and 1.08 for Hispanic women. The severe maternal morbidity rate increased significantly during the study period among each of the five racial and ethnic groups but started declining in 2012. During the entire study period, the failure-to-rescue rate decreased significantly.

"Our study confirms that excess maternal mortality continues to be a serious public health problem and improving the quality of obstetric care, especially for Black and other minority women, could help substantially decrease maternal mortality and reduce racial and ethnic disparities in maternal mortality in the United States," a coauthor said in a statement.

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