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Trends in maternal mortality in the United States
Institution:1. Division of Toxicology, Wageningen University, The Netherlands;2. National Institute of Public Health and the Environment (RIVM), Bilthoven, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands;3. BASF SE, Experimental Toxicology and Ecology, Ludwigshafen, Germany;1. Institute for Health Metrics and Evaluation, Seattle, WA, USA;2. Department of Neurology, Seattle, WA, USA;3. Pediatric Anesthesiology and Pain Medicine, Seattle Children''s Hospital, School of Medicine, Seattle, WA, USA;4. University of Washington, Seattle, WA, USA;5. Hacettepe University Institute of Population Studies, Ankara, Turkey;6. Faculty of Medicine, Cairo University, Cairo, Egypt;7. School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Tigray, Ethiopia;10p. University College London, London, UK;8. Ministry of Health, Gaborone, Botswana;9. Public Health Promotion Alliance, Osogbp, Nigeria;10. Centre for International Child Health, Melbourne, VIC, Australia;11. University of Melbourne, Melbourne, VIC, Australia;12. Association Ivoirienne Pour Le Bien Etre Familial, Abidjan, Côte d''Ivoire;13. University of Extremadura, Cáceres, Spain;14. Institution of Public Health Sciences, Stockholm, Sweden;15. Makerere University, Kampala, Uganda;p. Ministry of Health, Muscat, Oman;q. Debre Markos University, Debre Markos, Amhara, Ethiopia;r. National Guard Health Affairs, Riyadh, Saudi Arabia;s. University of Oxford, Oxford, UK;t. School of Public Health, University of Lorraine, Nancy, France;u. Ministry of Health, Belmopan, Cayo, Belize;v. Saudi Ministry of Health, Riyadh, Saudi Arabia;w. Charité Universitätsmedizin Berlin, Berlin, Germany;x. Spanish Observatory on Drugs, Government Delegation for the National Plan on Drugs, Madrid, Spain;y. Division of Pharmacoepidemiology and Pharmacovigilance, Spanish Medicines and Healthcare Products Agency, Madrid, Spain;z. Ministry of Health, Social Services and Equality, Madrid, Spain;11. Universidad de Cartagena, Cartagena de Indias, Colombia;12. Albany State University, Albany, GA, USA;13. Department of Epidemiology, University of Groningen, Groningen, Netherlands;14. College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia;15. Kurdistan Environmental Health Research Centre, Kurdistan University of Medical Sciences, Sanandaj, Kurdistan, Iran;16. Ministry of Public Health, Beirut, Lebanon;17. College of Public Health, University of the Philippines Manila, Manila, Philippines;18. UN Population Fund, Kabul, Afghanistan;19. Uppsala University, Uppsala, Sweden;110. Institute of Microbiology and Immunology, School of Medicine, University of Belgrade, Belgrade, Serbia;111. Median, Windsor, ON, Canada;112. Ministry of Health, Amman, Jordan;113. Field Epidemiology and Laboratory Training Program, Islamabad, Pakistan;114. Mashhad University of Medical Sciences, Mashhad, Iran;115. Ministry Of Health, Wellness, Human Services and Gender Relations, Sans Souci, Castries, Saint Lucia;1p. Public Health Agency of Canada, Toronto, ON, Canada;1q. Sri Ramachandra University, Chennai, India;1r. School of Health Sciences, University of Canterbury, Christchurch, New Zealand;1s. School of Medicine, Stanford, CA, USA;1t. Stanford University, Stanford, CA, USA;1u. Oxford University, Ho Chi Minh City, Vietnam;1v. College of Public Health and Tropical Medicine, Jazan, Saudi Arabia;1w. Madawalabu University, Bale Goba, Oromia, Ethiopia;1x. Yale University, New Haven, CT, USA;1y. King''s College London, London, UK;1z. Addis Ababa University, Debre Zeit, Ethiopia;21. Aga Khan University Medical Centre, Karachi, Pakistan;22. Aga Khan University, Karachi, Pakistan;23. University of Missouri-Kansas City, Kansas City, MO, USA;24. General Directorate of Health Research, Ankara, Turkey;25. Ministry of Health, Ankara, Turkey;26. World Bank, Washington, DC, USA;27. University of Arizona, Tucson, AZ, USA;28. Universidad Autonoma Metropolitana, Mexico City, Mexico;29. Colombian National Health Observatory, Instituto Nacional de Salud, Bogota, Colombia;210. Universidad Diego Portales, Santiago, Chile;211. College of Public Health, Taipei, Taiwan;212. National Taiwan University, Taipei, Taiwan;213. National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA;214. Cyprus University of Technology, Limassol, Cyprus;215. Cedars-Sinai Medical Centre, Los Angeles, CA, USA;2p. University of Salerno, Baronissi, Italy;2q. Mayo Clinic, Rochester, MN, USA;2r. Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK;2s. National School of Public Health (ENSP/Fiocruz), Rio de Janeiro, Brazil;2t. Public Health Foundation of India, New Delhi, India;2u. Public Health England, London, UK;2v. School of Medicine, Atlanta, GA, USA;2w. Emory University, Atlanta, GA, USA;2x. The Kirby Institute, Sydney, NSW, Australia;2y. University of New South Wales, Sydney, NSW, Australia;2z. Griffith University, Brisbane, QLD, Australia;31. University of Auckland, Auckland, New Zealand;32. Africa Medical and Research Foundation in Ethiopia, Addis Ababa, Ethiopia;33. Hospital for Sick Children, University of Toronto, Toronto, ON, Canada;34. University of Peradeniya, Peradeniya, Sri Lanka;35. Harvard School of Public Health, Boston, MA, USA;36. Harvard University, Boston, MA, USA;37. Hatter Institute for Cardiovascular Research in Africa, Faculty of Health Sciences, Cape Town, South Africa;38. University of Cape Town, Cape Town, South Africa;39. Sydney School of Public Health, NSW, Australia;310. University of Sydney, NSW, Australia;311. The Institute of Social and Economic Studies of Population at the Russian Academy of Sciences, Moscow, Russia;312. Non-Communicable Diseases Research Centre, Tehran University of Medical Sciences, Tehran, Iran;313. Endocrinology and Metabolism Research Centre, Tehran University of Medical Sciences, Tehran, Iran;314. Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran;315. MS Research Centre, Tehran University of Medical Sciences, Tehran, Iran;813. Sina Trauma and Surgery Research Centre, Tehran University of Medical Sciences, Tehran, Iran;3p. Departamento de Saúde Pública, ARS Norte IP, Porto, Portugal;3q. Department of Medical Epidemiology and Biostatistics, Stockholm, Sweden;3r. Karolinska Institutet, Stockholm, Sweden;3s. Northern Region Health Administration, Porto, Portugal;3t. Public Health Department, Unidade Local de Saúde de Matosinhos, Porto, Portugal;3u. Federal University of Minas Gerais, Belo Horizonte, Brazil;3v. National Centre for Disease Control and Public Health of Georgia, Tbilisi, Georgia;3w. Clinique Coopérative de Parakou, Parakou, Borgou, Benin;3x. Public Health Unit of Primary Health Care Group of Almada-Seixal, Almada, Setúbal, Portugal;3y. Division of Human Nutrition, Wageningen University, Wageningen, Netherlands;3z. Monash University, Melbourne, VIC, Australia;41. University Hospital of Dijon, Dijon, France;42. Heller School for Social Policy and Management, Waltham, MA, USA;43. Brandeis University, Waltham, MA, USA;44. Ministry of Labour, Health and Social Affairs, Tbilisi, Georgia;45. University of Massachusetts Medical School, Worcester, MA, USA;46. National Institute of Public Health, Cuernavaca, Mexico;47. Department of Diabetes Research, National Centre for Global Health and Medicine, Tokyo, Japan;48. School of Population Health, QLD, Australia;49. University of Queensland, Brisbane, QLD, Australia;410. Saint James School of Medicine, Kralendijk, Bonaire, Netherlands;411. Kanawha Charleston Health Department, Charleston, WV, USA;412. Fortis Escorts Hospital, Jaipur, India;413. Arabian Gulf University, Manama, Bahrain;414. Wayne County Department of Health and Human Services, Detroit, MI, USA;415. School of Medicine and Pharmacology, University of Western Australia, Perth, WA, Australia;4p. Parnassia Psychiatric Institute, The Hague, Netherlands;4q. Albert Einstein College of Medicine, Bronx, NY, USA;4r. Public Health Division, Secretariat of the Pacific Community, Noumea, New Caledonia;4s. Birzeit University, Birzeit, Ramallah, Palestine;4t. National Institute for Health Development, Tallinn, Estonia;4u. School of Public Health, Tokyo, Japan;4v. Graduate School of Medicine, Tokyo, Japan;4w. University of Tokyo, Tokyo, Japan;4x. George Mason University, Fairfax, VA, USA;4y. Ochsner Medical Centre, New Orleans, LA, USA;4z. Graduate School of Public Health, Yonsei University, Seoul, South Korea;51. Postgraduate Institute of Medical Education and Research, Chandigarh, India;52. Tianjin Centres for Diseases Control and Prevention, Tianjin, China;10q. Department of Ophthalmology, Medical Faculty Mannheim, University of Heidelberg, Heidelberg, Germany;53. National Institute of Public Health, Copenhagen, Denmark;54. Vanderbilt University, Nashville, TN, USA;55. Fudan University, Shanghai, China;56. University of Balamand, Beirut, Lebanon;57. Helmholtz Centre for Infection Research, Braunschweig, Germany;58. Malaria and Other Parasitic Diseases Division, Kigali, Rwanda;59. Ministry of Health, Kigali, Rwanda;510. Oklahoma State University, Tulsa, OK, USA;511. University of California San Francisco, San Francisco, CA, USA;512. University of São Paulo, São Paulo, Brazil;513. South African Medical Research Council, Cape Town, South Africa;514. Jordan University of Science and Technology, Al-Ramtha, Jordan;515. Supreme Council of Health, Doha, Qatar;5p. Health Services Academy, Islamabad, Pakistan;5q. Institute of Health Policy and Management, Seoul National University College of Medicine, Seoul, South Korea;5r. Department of Preventive Cardiology, Department of Preventive Medicine and Epidemiologic Informatics, National Cerebral and Cardiovascular Centre, Suita, Japan;5s. Centre for Community Empowerment, Health Policy and Humanities, National Institute of Health Research and Development, Jakarta, Indonesia;5t. University of Montreal, Montreal, QC, Canada;5u. Rajrajeshwari Medical College and Hospital, Bangalore, India;5v. Arkansas State University, Jonesboro, AR, USA;5w. International Institute for Population Sciences, Mumbai, India;5x. Indian Institute of Public Health, Public Health Foundation of India, Gurgaon, India;5y. Boston Medical Centre, Boston, MA, USA;5z. Fourth View Consulting, Tallinn, Estonia;61. Australian Research Centre for Population Oral Health (ARCPOH), School of Dentistry, University of Adelaide, Adelaide, SA, Australia;62. Institute of Health Policy and Development Studies, National Institutes of Health, Manila, Philippines;63. International Agency for the Prevention of Blindness and Vision 2020, Weston, FL, USA;64. Korea University, Seoul, South Korea;65. University at Albany, Rensselaer, NY, USA;66. National Centre for Birth Defects Monitoring of China, Chengdu, China;67. National Centre for Chronic and Non-Communicable Disease Control and Prevention, Beijing, China;68. National Institute of Occupational Health and Poison Control, Beijing, China;69. Chinese Centre for Disease Control and Prevention, Beijing, China;610. Genentech, South San Francisco, CA, USA;611. National Office for Maternal and Child Health Surveillance, West China Second University Hospital, Sichuan University, Chengdu, China;612. Wayne State University, Miami, FL, USA;613. National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA;614. Ministry of Health Singapore, Singapore, Singapore;615. Xpharmconsult, Kumasi, Ghana;6p. Department of Public Health, Faculty of Health Sciences and Social Work, Trnava University, Trnava, Slovakia;6q. University of Zambia, Lusaka, Zambia;6r. Queen Mary University of London, London, UK;6s. University of the East Ramon Magsaysay Memorial Medical Centre, Quezon City, Philippines;6t. University of York, York, UK;6u. Janakpuri Super Specialty Hospital, New Delhi, India;6v. UN Population Fund, Lima, Peru;6w. Pacific Institute for Research and Evaluation, Calverton, MD, USA;6x. University of Ottawa, Ottawa, ON, Canada;6y. University of Papua New Guinea, Port Moresby, Papua New Guinea;6z. Institute for Maternal and Child Health Istituto di Ricovero e Cura a Carattere Scientifico Burlo Garofolo, Trieste, Italy;71. Bureau of International Health Cooperation, Manila City, Philippines;72. University of North Texas, Denton, TX, USA;10r. Iran University of Medical Sciences, Department of Community Medicine, Tehran, Iran;73. National Centre for Child Health and Development, Setagaya, Tokyo, Japan;74. Philipps-University Marburg, Marburg, Germany;75. Tokyo Medical and Dental University, Tokyo, Japan;76. International Centre for Diarrhoeal Diseases Research, Dhaka, Bangladesh;77. University of KwaZulu-Natal, Durban, South Africa;78. Ministry of Health Fiji, Suva, Fiji;79. Suraj Eye Institute, Nagpur, India;710. School of Public Health, State University of New York, New York, NY, USA;711. Faculty of Medicine, Fez, Morocco;712. National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix, AZ, USA;713. Norwegian Centre for Addiction Research (SERAF), University of Oslo, Oslo, Norway;714. Kenya Medical Research Institute Wellcome Trust Programme, Kilifi, Kenya;715. Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain;7p. University of Bergen, Bergen, Norway;7q. Kyung Hee Unversity, Seoul, South Korea;7r. Teikyo University School of Medicine, Tokyo, Japan;7s. Centre for Healthy Start Initiative, Lagos, Nigeria;7t. Lira District Local Government, Lira Municipal Council, Lira, Uganda;7u. Toxicology Unit, Faculty of Pharmacy, University of Port Harcourt, Port Harcourt, Nigeria;7v. Christian Medical College Ludhiana, Ludhiana, India;7w. Sungkyunkwan University School of Medicine, Suwon, South Korea;7x. Universidad de Cartagena, Cartagena, Colombia;7y. University of Calgary, Calgary, AB, Canada;7z. All India Institute of Medical Sciences (AIIMS), New Delhi, India;81. WHO, Waigani, Papua New Guinea;82. London School of Hygiene & Tropical Medicine, London, UK;83. 3B''s Research Group in Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, and ICVS/3B''s PT Government Associate Laboratory, Braga Portugal;84. Flinders University, Adelaide, SA, Australia;85. Centre for Applied Biostatistics, Sahlgrenska Academy, University of Gothenburg, Sweden;86. McMaster University, Hamilton, ON, Canada;87. Erasmus Medical Center, Department of Public Health, Rotterdam, Netherlands;88. University of Liverpool, Liverpool, UK;89. University of British Columbia, Vancouver, BC, Canada;810. College of Pharmacy, Chicago, IL, USA;811. University of Illinois, Chicago, IL, USA;812. Contech International, Lahore, Pakistan;814. Hamad Medical Corporation, Doha, Qatar;815. University of Missouri, Columbia, MO, USA;8p. Department of Public Health, University of the Punjab, Lahore, Pakistan;8q. Walden University, Minneapolis, MN, USA;8r. Bhaba Atomic Research Center Hospital, Mumbai, India;8s. Marshall University, Huntington, WV, USA;8t. Federal University of Santa Catarina, Florianópolis, Brazil;8u. University of Alabama at Birmingham, Birmingham, AL, USA;8v. Stellenbosch University, Cape Town, South Africa;8w. Health Canada, Ottawa, ON, Canada;8x. Heriot-Watt University, Edinburgh, UK;8y. Reykjavik University, Reykjavik, Iceland;8z. University of Pennsylvania, Philadelphia, PA, USA;91. Instituto Nacional de Epidemiología Dr Juan H Jara, Mar del Plata, Buenos Aires, Argentina;92. Norwegian Institute of Public Health, Oslo, Norway;93. Federal Research Institute for Health Organisation and Informatics of Ministry of Health of the Russian Federation, Moscow, Russia;94. Department of Clinical Neurological Sciences, Western University, London, ON, Canada;95. University Tunku Abdul Rahman, Kajang, Malaysia;96. Hellenic Centre for Disease Control and Prevention (KEELPNO) Greece, Athens, Greece;97. Department of Criminology, Law and Society (and Sociology), University of California Irvine, Irvine, CA, USA;98. Ministry of Public Health, Yaounde, Cameroon;99. Memorial University, St John''s, NL, Canada;910. Department of Anesthesiology, University of Virginia, Charlottesville, VA, USA;911. Department of Anesthesiology, King Fahad Medical City, Riyadh, Saudi Arabia;912. The Earth Institute, Columbia University, New York, NY, USA;913. Cincinnati Children''s Hospital Medical Centre, Cincinnati, OH, USA;914. Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA;915. Department of Medicine, University of Crete, Heraklion, Greece;9p. Department of Veterans Affairs, Washington, DC, USA;9q. Department of Internal Medicine, Federal Teaching Hospital Abakaliki, Abakaliki, Nigeria;9r. National Institute for Public Health and the Environment, Bilthoven, Netherlands;9s. UKK Institute for Health Promotion Research, Tampere, Finland;9t. Neuroscience Centre, Raffles Hospital, Singapore;9u. University of Bologna, Bologna, Italy;9v. Higher School of Economics, Moscow, Russia;9w. Uniformed Services University of Health Sciences, Bethesda, MD, USA;9x. Shandong University Affiliated Jinan Central Hospital, Jinan, China;9y. Murdoch Children''s Research Institute, Royal Children''s Hospital, Melbourne, VIC, Australia;9z. University of Miami, Miami, FL, USA;101. Institute of Public Health, University of Gondar, Gondar, Ethiopia;102. Ateneo School of Medicine and Public Health, City of Pasig, Manila, Philippines;103. Jimma University, Jimma, Ethiopia;104. Nanjing University School of Medicine, Jinling Hospital, Nanjing, China;105. University of North Carolina at Chapel Hill, Chapel Hill, NC, USA;106. Division of Cardiovascular Medicine, Jichi Medical University School of Medicine, Shimotsuke, Japan;107. University of Hong Kong, Hong Kong Special Administrative Region, China;108. National Centre of Neurology and Psychiatry, Kodaira, Japan;109. Jackson State University, Jackson, MS, USA;1010. Department of Epidemiology and Biostatistics, Global Health Institute, School of Public Health, Wuhan University, Wuhan, China;1011. TCM Medical Tk, Nusajaya, Johor Bahru, Malaysia;1012. Mansoura Faculty of Medicine, Mansoura, Egypt;1013. Chongqing Medical University, Chongqing, China;1014. Zhongshan Ophthalmic Centre, Sun Yat-sen University, Guangzhou, China;1015. Cancer Institute and Hospital, Chinese Academy of Medical Sciences, Beijing, China;1. Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA;2. National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD;3. Maternal and Child Health Bureau, Health Resources and Services Administration, Rockville, MD;1. University of Massachusetts Amherst, Amherst, MA, USA;2. World Health Organization, Geneva, Switzerland;3. Harvard University, Cambridge, MA, USA;4. University of California, Berkeley, CA, USA;1. Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA;2. Division of Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA;3. Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women''s Hospital, and Department of Anesthesiology, Critical Care, and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA
Abstract:Maternal mortality is a major global concern. Although a notable decline in maternal mortality in the United States occurred during the mid-20th century, this progress stalled during the late 20th century. Furthermore, maternal mortality rates have increased during the early 21st century. Around the year 2000 the maternal mortality rate began to rise and has since nearly doubled. Given that at least half of maternal deaths in the U.S. are preventable, the rise in maternal deaths in the U.S. is historic and worrisome. This overview will try to provide a context for understanding the problem of this rise in maternal mortality in the U.S. by briefly discussing how maternal mortality rates are reported from National Vital Statistics data and from a National Surveillance system. Trends and causes of maternal deaths and the difficulty with interpreting these trends will be discussed.
Keywords:Maternal mortality  Pregnancy-related mortality  Maternal mortality ratio  Developed and developing countries
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