Maternal mortality in women aged 35 years or older: United States
J. W. Buehler, A. M. Kaunitz, C. J. Hogue, J. M. Hughes, J. C. Smith and R. W. Rochat
To examine maternal mortality among women aged 35 years or older, we used
death certificates from the United States for 1974 through 1978. There were
425 maternal deaths, corresponding to a mortality rate of 58.3 deaths per
100,000 live births. This rate was higher than the rate for women 20
through 34 years of age (race-adjusted relative risk [RR] = 4.0; 95%
confidence interval [CI], 3.6 to 4.4). The leading causes of death were
obstetric hemorrhage and embolism. Black women had higher mortality rates
than white women for deaths without abortive outcomes (RR = 3.3; CI, 2.7 to
4.1) and with abortive outcomes (RR = 9.4; 95% CI, 5.8 to 15.3), and the
latter difference was largely due to a higher rate of deaths associated
with ectopic pregnancy among black women. From 1974 through 1978, compared
with 1982, maternal mortality rates for women aged 35 years or older
reported by the National Center for Health Statistics declined
approximately 50%. Among white women, changes in age and parity accounted
for less than half of this decrease, suggesting that improvements have
occurred in age- and parity-specific mortality for women aged 35 years or
older.
