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The contribution of heart disease to pregnancy-related mortality according to the pregnancy mortality surveillance system

Journal of Perinatology volume 32, pages 163–169 (2012)Cite this article

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Abstract

Objective:

The objective of this study was to demonstrate the increasing importance of heart disease as a cause of pregnancy-related mortality in Hawaii and the rest of the United States.

Study Design:

Hawaii's Department of Public Health identified all pregnancy-associated death certificates from 1991 to 2007. Hospital records and autopsy reports were reviewed to determine whether deaths were pregnancy-related.

Result:

From 1991 to 2007, Hawaii registered 156 deaths occurring within 1 year of pregnancy, which represented 4.2% of the total number of women who died in the same 17 to 46 years age group and 9.0% of the total number of women who died in the same 17 to 34 years age group. The pregnancy-related mortality ratio was 22.4 and the pregnancy-associated mortality ratio was 50. The leading cause of pregnancy-associated mortality was heart disease (20.5%) followed by cancer (18.6%) and suicide/homicide (12.2%). Pregnancy-related deaths (n=70) were attributed to heart disease (45.7%) followed by sepsis (14.2%) and hemorrhage (12.9%). The new Hawaii death certificate beginning in 2006 increased the detection of both pregnancy-related and -associated deaths.

Conclusion:

Heart disease is the most common cause of pregnancy-related mortality in Hawaii, and with improved ascertainment, may be determined to be the most common cause of pregnancy-related mortality in the rest of the United States.

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Acknowledgements

This work was supported by the National Institutes of Health (U54 RR014607).

Author information

Authors and Affiliations

  1. Department of Obstetrics, University of Hawaii, John A. Burns School of Medicine, Gynecology and Women's Health, Honolulu, HI, USA

    J Burlingame & L M Sauvage

  2. Department of Health, State of Hawaii, Honolulu, Hawaii, USA

    B Horiuchi & A Onaka

  3. Research Corporation of the University of Hawaii, Honolulu, HI, USA

    P Ohana

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  1. J Burlingame
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  2. B Horiuchi
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  3. P Ohana
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  4. A Onaka
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  5. L M Sauvage
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Correspondence to J Burlingame.

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Burlingame, J., Horiuchi, B., Ohana, P. et al. The contribution of heart disease to pregnancy-related mortality according to the pregnancy mortality surveillance system. J Perinatol 32, 163–169 (2012). https://doi.org/10.1038/jp.2011.74

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