Wednesday, April 11, 2018

Mistakes and corrections in Texas maternal mortality

I was alarmed by the jump in the Texas maternal mortality rate reported last year, so I was relieved to see that the data on which that report was based were in error.
This week, the Texas Maternal Mortality and Morbidity Task Force released a study in Obstetrics & Gynecology that found the maternal morbidity figures from 2012 — which had Texas mothers dying at rates that shocked experts and the public — were based on sloppy and erroneous data collection.
So sloppy, in fact, that more than half of the deaths that were recorded as pregnancy-related that year were recorded that way in error.
In 2016, Texas made national headlines after research that was also published in Obstetrics & Gynecology highlighted that the state’s maternal mortality rate had mysteriously skyrocketed in just two short years between 2010 and 2012. In 2012, for example, 148 Texas mothers died of pregnancy-related complications compared to 72 in 2010, the study found. The national figure in 2013 was 28.
To correct the statistics, the Texas Maternal Mortality and Morbidity Task Force, which had been established to study the maternal mortality rate issue in 2013, cross-referenced death certificates, birth certificates and a year’s worth of medical records for all 147 women in the state’s records. They found that, in fact, there were only 56 deaths that fell under the definition of maternal mortality — any pregnancy-related death while a woman is pregnant or within 42 days of giving birth, excluding accidental or incidental causes such as car crashes or homicide.
After all of the data-collection errors were excluded, Texas’s 2012 maternal mortality rate was corrected from 38.4 deaths per 100,000 live births to 14.6 per 100,000 live births.
Citing 2015 research published in the Lancet, NPR and ProPublica reported the U.S. maternal mortality rate to be 26.4 per every 100,000 live births in 2015. Compare that to Britain’s 9.2, Australia’s 5.5 and Finland’s 3.8 per 100,000 live births. As The Washington Post reported last month, the District of Columbia has an estimated rate of 41 per 100,000 deaths according to a 2010 to 2014 analysis from the United Health Foundation, which has puzzled officials as well.
Given the problems with data collection on maternal morality discussed in the article, I now wonder how robust the overall US figure is.


  1. How well should the revised data be trusted? This question is not a matter of simple devil's advocacy.

  2. I was wondering that myself---but we can only wait and see what future research shows