Enhancing reviews and surveillance to eliminate maternal mortality - maternal mortality (MM) and morbidity are key indicators of the health of a society and serve as measures for the overall health…

Enhancing reviews and surveillance to eliminate maternal mortality - maternal mortality (MM) and morbidity are key indicators of the health of a society and serve as measures for the overall health and well-being of a community. Maternal deaths are devastating events with prolonged effects on partners, children, families and health care teams. According to new york state (NYS) vital statistics and the centers for disease control and prevention (CDC) wonder database, the MM ratio in NYS peaked at 24.4 per 100,000 live births in 2008-2010 but decreased to 19.3 per 100,000 live births in 2018-2020. Further, racial and ethnic disparities continue to be significant in NYS. The 2018-2020 NYS maternal mortality review (MMR) results reveal that non-hispanic black people have a pregnancy-related (PR) mortality ratio (PRMR) 4.8 times higher than non-hispanic white people. People living in new york city (NYC) have a higher risk of PR deaths than people living in rest of state (ROS), with racial and ethnic disparities persisting within both regions. Non-hispanic black people living in ROS have a PRMR 3.8 times higher than non-hispanic white people, while non-hispanic black people living in NYC have a PRMR 4.5 times higher than non-hispanic white people. Findings from NYS and NYC maternal mortality review committees (MMRCS) indicate that more than 70% of pregnancy-related deaths were preventable. NYS has two functioning MMRCS that collaborate to conduct comprehensive reviews using multiple sources of clinical and non-clinical information to identify factors leading to MM, which inform interventions focused on reducing the incidence of these deaths and other health disparities. The mmrc led by the NYC department of health and mental hygiene (DOHMH) reviews deaths that occur within NYC, while the mmrc led by the NYS department of health (DOH) reviews all ROS maternal deaths. Receipt of this funding will enhance the work already undertaken by the DOH and DOHMH by coordinating these two MMRCS in working jointly to identify and characterize pregnancy-related deaths, provide a deeper understanding of the circumstances surrounding a death to develop and implement data-informed strategies for prevention and reduce disparities and related health inequities. The objectives of DOH and DOHMH and their two MMRCS are: 1) to systematically and comprehensively conduct reviews of maternal deaths, 2) facilitate an understanding of the drivers of maternal mortality and complications of pregnancy and associated disparities, and 3) develop recommended strategies to support the implementation of policies, programs, and initiatives to prevent future deaths. Short-term and immediate outcomes of these reviews will include increased timeliness, accuracy, and standardization of information available about pregnancy-related deaths, including informant interviews to inform individual case reviews and case narrative development and the identification of opportunities for prevention from multidisciplinary and diverse MMRCS; increased engagement and cooperation between MMRCS, partners, and communities to communicate information on pregnancy-related deaths; increased availability of recommendations among communities, clinicians, public health practitioners, and decision makers; and increased implementation and adoption of clinical and non-clinical recommendations that reach the needs of populations disproportionately affected by PR mortality. The long-term outcome of the MMRCS' processes will be to reduce disparities in maternal complications of pregnancy, including improving population health maternal health outcomes. This funding will support the capacity of DOH and DOHMH to increase overall timeliness, quality, and availability of information on strategies for prevention of pregnancy-related deaths and reduction of disparities in pregnancy-related mortality.