{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T14:25:23Z","timestamp":1776435923318,"version":"3.51.2"},"reference-count":46,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2016,2,18]],"date-time":"2016-02-18T00:00:00Z","timestamp":1455753600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J of Obstet and Gynaecol"],"published-print":{"date-parts":[[2016,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>To characterize the most common causes and risk factors of maternal mortality in the<jats:styled-content style=\"fixed-case\">USA<\/jats:styled-content>and observe trends over the past 9 years.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We carried out a population\u2010based retrospective cohort study using data from the Health Care Cost and Utilization Project, Nationwide Inpatient Sample. Women who were pregnant between 2003 and 2011 were identified. Baseline characteristics of pregnant women who died and those who lived were measured. ICD\u20109 codes for each cause of death were examined by up to three independent reviewers. Causes of death were categorized into the nine most common subgroups and trends were examined by tertiles of the period 2003\u20132011.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>During this 9\u2010year period, there were approximately 7 million births and 1102 maternal deaths, for an overall incidence of 14.2 per 100 000 births. Primary causes of maternal death included sepsis (20.6%), cardiac disease (17.8%), hemorrhage (16.2%), venous thromboembolism (15.2%), and hypertensive disorders (9.4%). During the study period, there was a significant decrease in the frequency of sepsis from 33.2% to 10.0% and a non\u2010significant decrease in venous thromboembolism from 19.1% to 12.9%. There were increases noted in all other groups, notably in terms of hemorrhage from 8.2% to 22.0% and hypertensive disorders from 2.1% to 16.4%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Maternal mortality remains a rare event. Although sepsis was the overall predominant cause of mortality during the study period, frequency declined over time and it was surpassed by hemorrhage and hypertensive disorders as the leading causes of maternal mortality.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jog.12954","type":"journal-article","created":{"date-parts":[[2016,2,18]],"date-time":"2016-02-18T22:11:40Z","timestamp":1455833500000},"page":"661-668","source":"Crossref","is-referenced-by-count":43,"title":["Incidence and causes of maternal mortality in the<scp>USA<\/scp>"],"prefix":"10.1111","volume":"42","author":[{"given":"Anita","family":"Kuriya","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Jewish General Hospital, McGill University Montreal Quebec Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sabrina","family":"Piedimonte","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Jewish General Hospital, McGill University Montreal Quebec Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea R.","family":"Spence","sequence":"additional","affiliation":[{"name":"Center for Clinical Epidemiology and Community Studies Jewish General Hospital Montreal Quebec Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicholas","family":"Czuzoj\u2010Shulman","sequence":"additional","affiliation":[{"name":"Center for Clinical Epidemiology and Community Studies Jewish General Hospital Montreal Quebec Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abbas","family":"Kezouh","sequence":"additional","affiliation":[{"name":"Center for Clinical Epidemiology and Community Studies Jewish General Hospital Montreal Quebec Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haim A.","family":"Abenhaim","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Jewish General Hospital, McGill University Montreal Quebec Canada"},{"name":"Center for Clinical Epidemiology and Community Studies Jewish General Hospital Montreal Quebec Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2016,2,18]]},"reference":[{"key":"e_1_2_7_2_1","volume-title":"2011 Women's Health Stats and Facts","author":"The American Congress of Obstetricians and Gynecologists","year":"2011"},{"key":"e_1_2_7_3_1","unstructured":"World Health Organization. Maternal Mortality2014[cited 5 November 2014] Available from URL: http:\/\/www.who.int\/mediacentre\/factsheets\/fs348\/en\/."},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.045156"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1363\/3903213"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e31826d60c5"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/birt.12041"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2014.06.046"},{"key":"e_1_2_7_9_1","first-page":"158","article-title":"Pregnancy related causes of deaths in Ghana: A 5\u2010year retrospective study","volume":"47","author":"Der EM","year":"2013","journal-title":"Ghana Med J"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.12374"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1080\/07399332.2014.908193"},{"key":"e_1_2_7_12_1","unstructured":"Healthcare Cost and Utilization Project (HCUP).Overview of the National (Nationwide) Inpatient Sample (NIS)2014[cited 5 October 2014] Available from URL: http:\/\/www.hcup\u2010us.ahrq.gov\/nisoverview.jsp."},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(14)70227-X"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e3182a7dc8c"},{"key":"e_1_2_7_15_1","first-page":"1","article-title":"Maternal mortality and related concepts","volume":"3","author":"Hoyert DL","year":"2007","journal-title":"Vital Health Stat"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/MOH.0000000000000091"},{"key":"e_1_2_7_17_1","first-page":"1","article-title":"Pregnancy\u2010related mortality surveillance\u2013United States, 1991\u20131999","volume":"52","author":"Chang J","year":"2003","journal-title":"MMWR Surveill Summ"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)60518-1"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.114.001056"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1080\/10810730.2013.825677"},{"key":"e_1_2_7_21_1","first-page":"1","article-title":"Births in the United States, 2013","volume":"175","author":"Martin JA","year":"2014","journal-title":"NCHS Data Brief"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1701-2163(16)35138-6"},{"key":"e_1_2_7_23_1","first-page":"24","article-title":"The epidemiology of maternal overweight in Dane County, Wisconsin","volume":"113","author":"Zeal C","year":"2014","journal-title":"WMJ"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2005.072975"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2009.10.864"},{"key":"e_1_2_7_26_1","unstructured":"GuerraM.Fact Sheet: The State of African American Women in the United States.2013. [Cited 15 Jan 2015.] Available from URL: https:\/\/www.americanprogress.org\/issues\/race\/report\/2013\/11\/07\/79165\/fact\u2010sheet\u2010the\u2010state\u2010of\u2010african\u2010american\u2010women\u2010in\u2010the\u2010united\u2010states\/"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2010.02847.x"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0067175"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000447100.08050.cd"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1097\/GCO.0b013e32835e0e82"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000000175"},{"key":"e_1_2_7_32_1","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pmed.1001672","article-title":"Severe maternal sepsis in the UK, 2011\u20132012: A national case\u2013control study","volume":"11","author":"Acosta CD","year":"2014","journal-title":"PLoS Med"},{"key":"e_1_2_7_33_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2011.03239.x"},{"key":"e_1_2_7_34_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.semperi.2011.09.010"},{"key":"e_1_2_7_35_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000000219"},{"key":"e_1_2_7_36_1","doi-asserted-by":"publisher","DOI":"10.1097\/GRF.0000000000000062"},{"key":"e_1_2_7_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2014.05.013"},{"key":"e_1_2_7_38_1","doi-asserted-by":"publisher","DOI":"10.3109\/14767058.2014.955004"},{"key":"e_1_2_7_39_1","doi-asserted-by":"crossref","first-page":"2241","DOI":"10.3760\/cma.j.issn.0366-6999.20133118","article-title":"Effect of maternal age on pregnancy: A retrospective cohort study","volume":"127","author":"Liu X","year":"2014","journal-title":"Chin Med J (Engl)"},{"key":"e_1_2_7_40_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11883-013-0395-8"},{"key":"e_1_2_7_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2014.03.031"},{"key":"e_1_2_7_42_1","doi-asserted-by":"crossref","first-page":"25","DOI":"10.25100\/cm.v45i1.1466","article-title":"Reduction of maternal mortality due to preeclampsia in Colombia: An interrupted time\u2010series analysis","volume":"45","author":"Herrera JA","year":"2014","journal-title":"Colomb Med (Cali)"},{"key":"e_1_2_7_43_1","first-page":"563","article-title":"Venous thromboembolism in pregnancy: Current state of the art","volume":"104","author":"Ralli E","year":"2013","journal-title":"Minerva Med"},{"key":"e_1_2_7_44_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2014.07.024"},{"key":"e_1_2_7_45_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.midw.2013.09.001"},{"key":"e_1_2_7_46_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2008.03.007"},{"key":"e_1_2_7_47_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2014.03.053"}],"container-title":["Journal of Obstetrics and Gynaecology Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fjog.12954","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fjog.12954","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jog.12954","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,6,14]],"date-time":"2024-06-14T12:46:45Z","timestamp":1718369205000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/jog.12954"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,2,18]]},"references-count":46,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2016,6]]}},"alternative-id":["10.1111\/jog.12954"],"URL":"https:\/\/doi.org\/10.1111\/jog.12954","archive":["Portico"],"relation":{},"ISSN":["1341-8076","1447-0756"],"issn-type":[{"value":"1341-8076","type":"print"},{"value":"1447-0756","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,2,18]]}}}