{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T10:12:04Z","timestamp":1760955124722},"reference-count":13,"publisher":"American Public Health Association","issue":"9","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Public Health"],"published-print":{"date-parts":[[1977,9]]},"abstract":"<jats:p> An analysis was performed of direct maternal mortality over 22 years (1950 through 1971) in the state of Michigan. The overall direct maternal mortality rate fell from 5.0\/10,000 live births in 1950 to 1.5 in 1971. The rate among nonwhites was more than four times greater than among whites and the difference in relative risk did not narrow over the 22 years. Mortality rates increased with increasing maternal age but not with increasing parity. Nulliparous women had a significantly higher mortality rate than did parous women, particularly those over 25 years of age. when the white gravida of urban Wayne County were compared with the white gravida of 33 rural counties, no difference in direct maternal mortality rates could be attributed to rurality per se. Hemorrhage, infection, and toxemia were the leading causes of direct maternal death. The data suggest that hospitals with less active obstetrical services were associated with a higher risk of direct maternal mortality than were hospitals whose obstetrical services were more active. An increasing proportion of the direct maternal deaths was designated as preventable over the study period. It is believed that analyses of maternal mortality have led to improved perinatal and obstetrical care and that further advances require their continued support. (Am. J. Public Health 67:821-829, 1977) <\/jats:p>","DOI":"10.2105\/ajph.67.9.821","type":"journal-article","created":{"date-parts":[[2008,11,27]],"date-time":"2008-11-27T05:01:13Z","timestamp":1227762073000},"page":"821-829","source":"Crossref","is-referenced-by-count":22,"title":["Maternal Mortality in Michigan: An Epidemiologic Analysis, 1950-1971"],"prefix":"10.2105","volume":"67","author":[{"given":"William","family":"Schaffner","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charles F.","family":"Federspiel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mary L.","family":"Fulton","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Donna G.","family":"Gilbert","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lee B.","family":"Stevenson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"844","reference":[{"key":"p_1","first-page":"4","volume":"116","author":"Rolf B. B","year":"1972","journal-title":"California. Calif. Med."},{"key":"p_2","unstructured":"New York Academy of Medicine Committee on Public Health Relations: Maternal Mortality in New York City. A Study of All Puerperal Deaths 1930-1932. The Commonwealth Fund, New York: Oxford University Press, 1933."},{"key":"p_3","first-page":"123","volume":"34","author":"Marmol J. G.","year":"1969","journal-title":"Obstet. Gynecol."},{"key":"p_4","first-page":"569","volume":"50","author":"Antler J.","year":"1976","journal-title":"Bull. Hist. Med."},{"key":"p_5","unstructured":"Committee on maternal and child care of the council on medical services, American Medical Association: A guide for maternal death studies. Chicago, 1964."},{"key":"p_6","unstructured":"United States Department of Commerce. Bureau of the Census. 1970 Census of Population Vol 1, General Social and Economic Characteristics Pt 24, Michigan."},{"key":"p_7","unstructured":"Linder, F. E., Grove, R. D. Vital Statistical Rates in the United States 1900-1940. Washington, DC: U.S. Government Printing Office, 1943."},{"key":"p_8","doi-asserted-by":"publisher","DOI":"10.2307\/2282717"},{"issue":"62","key":"p_9","first-page":"67","volume":"26","author":"Center for Disease Control","year":"1977","journal-title":"Morbid Mortal Weekly Rep"},{"key":"p_10","unstructured":"Hellman, L. M., Pritchard, J. A., Wynn, R. M. Williams Obstetrics, 14th Ed. New York: Appleton-Century-Crofts, 1971, pg 5."},{"key":"p_11","first-page":"000","volume":"67","author":"Grimes D. A.","journal-title":"Am. J. Public Health"},{"key":"p_12","doi-asserted-by":"publisher","DOI":"10.2307\/4595029"},{"key":"p_13","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(76)90490-7"}],"container-title":["American Journal of Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/ajph.aphapublications.org\/doi\/pdf\/10.2105\/AJPH.67.9.821","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,5,9]],"date-time":"2022-05-09T17:18:10Z","timestamp":1652116690000},"score":1,"resource":{"primary":{"URL":"https:\/\/ajph.aphapublications.org\/doi\/full\/10.2105\/AJPH.67.9.821"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1977,9]]},"references-count":13,"journal-issue":{"issue":"9","published-print":{"date-parts":[[1977,9]]}},"alternative-id":["10.2105\/AJPH.67.9.821"],"URL":"https:\/\/doi.org\/10.2105\/ajph.67.9.821","relation":{},"ISSN":["0090-0036","1541-0048"],"issn-type":[{"value":"0090-0036","type":"print"},{"value":"1541-0048","type":"electronic"}],"subject":[],"published":{"date-parts":[[1977,9]]}}}