Analysis of Maternal Mortality Review in the UnitedStates

Analysis of Mortality Maternal Review in the United States Abstract Background: Maternal mortality has been a persistent concern locally, nationally, and globally. The maternal mortality rate in Texas has been rising since 2010 and is one of the worst rates in the U.S. In fact, the Texas rate is almost double that of the U.S. The Texas Maternal Mortality and Severe Morbidity Task Force (MMMTF) was set up within the Department of State Health Services (DSHS) to study and review cases of pregnancy-related causes of maternal mortality and severe morbidity. Other states have conducted similar reviews prior to Texas’ MMMTF. They have seen improvements in maternal mortality from the implementation of their recommendations. Objective: To compare and contrast previous maternal mortality and morbidity reviews of other states and determine its impact on the rate of maternal mortality because of the review. The results of these reviews can be used to guide the implementation of appropriate interventions to reduce the rate of maternal morbidity and mortality in Texas. Methodology: A review of literature and “grey” literature was conducted. Studies were selected based on the following criteria: state/city review, case definition of maternal mortality, year maternal mortality review was implemented, type of review (only medical records, family interviews, etc.), recommended/implemented interventions, and composition of the taskforce. Inclusion criteria consisted of publication period between 2007 and 2017, search terms “death review” and “maternal mortality”, and reviews within the United States. Exclusion criteria was comprised of countries outside of the U.S., and infant or other mortality reviews. Results: The review revealed that a maternal mortality surveillance system helps to identify interventions and recommendations unique to the needs of each State, making it difficult to compare effective practices across regions. However, evidence-based practices that have been successful with populations and infrastructures similar to Texas are worth considering. Conclusion: A state level review of maternal death allows in-depth analyses of the problem of maternal mortality. It allows for a richer, more nuanced picture than what would otherwise result from analysis of vital statistics. These conclusions can help establish a surveillance system and also have the potential to give rise to recommendations to address maternal morbidity and mortality.