US maternal mortality rates surge 28% from 2018 to 2022

US maternal mortality rates surge 28% from 2018 to 2022 | Image Credit: © Igor Borodin - © Igor Borodin - stock.adobe.com.

Rising maternal mortality in the United States

An increase in pregnancy-related deaths has been observed in the United States between 2018 and 2022, according to a recent study published in JAMA Network Open.¹

In 2015, the US maternal mortality rate was 26.4 per 100,000 live births, but Maternal Mortality Review Committees have reported that over 80% of deaths caused by pregnancy are preventable. These mortalities often occur with significant disparities, including a 2- to 3-fold increase in maternal mortality prevalence among non-Hispanic Black patients vs White patients.²

“Given the increasing median age at childbirth and the decreasing number of live births observed annually, a more detailed characterization of the current US pregnancy-related death rates with age-standardized estimates would help guide tailored interventions necessary to reduce avoidable pregnancy-related deaths,” wrote investigators.¹

Identifying trends in mortality

The cross-sectional study was conducted to identify trends in all-cause and cause-specific pregnancy-related US mortalities between 2018 and 2022. Nationwide data was obtained from the CDC Wide-Ranging Online Data for Epidemiologic Research.

Live births from US women aged 15 to 54 years were included in the analysis. These patients’ state, age group, race, and ethnicity data were extracted, alongside the age distribution of mothers from 2017.

Outcome data on pregnancy-related deaths was extracted from the Multiple Cause of Death database. This data was reported by state, 5-year age group, and race and ethnicity.

Definition of outcomes

Investigators defined all-cause pregnancy-related death as death occurring during pregnancy or within 1 year postpartum linked to the pregnancy. This included maternal death and late maternal death.

Late maternal death and cause-specific maternal death were reported as secondary outcomes. Investigators also investigated specific disease categories linked to late maternal death such as mental and behavioral disorder, endocrine disorder, malignant neoplasm, cardiovascular disorder, and drug-induced and alcohol-induced death.

Overall trends in pregnancy-related deaths

There were 6283 pregnancy-related deaths in the United States reported between 2018 and 2022, 1891 of which were late maternal deaths. This indicated an age-standardized annual and aggregated rate (ASR) of 33 deaths per 100,000 live births.

A 27.7% increase in the ASR was reported during the study period, from 25.3 deaths per 100,000 live births in 2018 to 32.6 per 100,000 in 2022. For late maternal deaths, these rates were 7.3 deaths per 100,000 live births to 11.1 per 100,000, respectively, partially driving the overall increase in maternal mortality.

Geographic and age-related variations

Over 3-fold variations in maternal mortality were observed between states, with the greatest rates reported in southeastern states. The highest rates of 59.7 deaths per 100,000 live births and 58.2 per 100,000 were reported in Alabama and Mississippi, respectively.

In comparison, the lowest rates of 18.5 deaths per 100,000 live births and 19.1 per 100,000 were reported in California and Minnesota, respectively. Among age groups, the highest increase in mortality of 36.8% was observed among women aged 25 to 39 years. This was followed by an increase of 25.8% among those aged 15 to 24 years.

Additional disparities and implications

Significant differences in mortality rates were also reported across racial and ethnic groups. American Indian and Alaska Native women had a 3.8-fold higher mortality rate than White women, at 106.3 deaths per 100.000 live births. In comparison, the ASR for non-Hispanic Black women was 76.9 per 100,000, indicating a 2.8-fold increase vs White women.

The mortality rate for other disorders predominantly related to pregnancy was 5.9 deaths per 100,000 live births, making it the most common underlying cause. This was followed by delivery and labor at 2.2 per 100,000. Overall, significant increases in maternal mortality were observed from 2018 to 2022 in the United States.

“Our analysis provides important insights that should inform the shared goal of preventing avoidable pregnancy-related deaths in the US,” wrote investigators.

References

1. Chen Y, Shiels MS, Uribe-Leitz T, et al. Pregnancy-related deaths in the US, 2018-2022. JAMA Netw Open. 2025;8(4):e254325. doi:10.1001/jamanetworkopen.2025.4325
2. Petersen EE, Davis NL, Goodman D, et al. Racial/ethnic disparities in pregnancy-related deaths—United States, 2007–2016. MMWR Morb Mortal Wkly Rep. 2019;68(35):762-765. doi:10.15585/mmwr.mm6835a3