Rates of Maternal Death in Texas

DSHS calculates maternal death rates two different ways. Both Texas maternal death rate reporting methods rely on death certificate information for identifying the number of maternal deaths, but differ in the time period after pregnancy that a death occurs.    

DSHS sends death certificates to the National Center for Health Statistics (NCHS) at the U.S. Centers for Disease Control and Prevention (CDC). NCHS uses information on the death certificate to assign an International Statistical Classification of Diseases and Related Health Problems (ICD-10) cause of death code. Specific ICD-10 codes are used to identify maternal deaths.  

Some errors on death certificates or incorrect coding might be contributing to an over-reporting of maternal deaths nationwide, especially among women of advanced childbearing age.1,2 A study by DSHS epidemiologists is underway to try to more accurately identify the number of maternal deaths and the rate of maternal death in Texas.    

Reported Rates of Maternal Death in Texas  

Method A: Texas Maternal Mortality Rate (MMR) within 42 Days Following End of Pregnancy

The Texas Maternal Mortality Rate (MMR) is the number of maternal deaths during pregnancy or within 42 days following the end of pregnancy for every 100,000 live births.

MMR has been reported since 2005 and is calculated from data from NCHS at CDC.  NCHS uses cause of death codes to identify the number of maternal deaths during the time period. The specific ICD-10 codes are A34, O00-O95, and O98-O99. Table 1 shows Texas MMR within 42 days following the end of pregnancy using NCHS data from 2010 to 2015.

 

Table 1. Texas Maternal Mortality Rate (MMR) within 42 Days Following End of Pregnancy, 2010-2015


Year Number of Deaths

Number of

Live Births

MMR
  • (per 100,000 live births)
  • 2015
131 403,618 32.5
  • 2014
135 399,766 33.8
  • 2013
140 387,340 36.1
  • 2012
148 382,727 38.7
  • 2011
114 377,445 30.2
  • 2010
72 386,118 18.6

Data Source: National Center for Health Statistics, U.S. Centers for Disease Control and Prevention  

This MMR for Texas can also be found in Maternal Mortality in Texas: Using Precision Public Health to Improve Maternal Outcomes and the report Appendix.  

A CDC query tool also makes information to calculate this MMR available for analysis.  

Method B: Texas Maternal Death Rate at Any Time Following End of Pregnancy  

The DSHS Center for Health Statistics (CHS) calculates a maternal death rate for Texas using the number of maternal deaths during pregnancy or at any time following the end of pregnancy. CHS calculates and reports this measure because NCHS has selected it as a leading cause of death measure. NCHS also reports on this measure.   

CHS uses cause of death coding provided by NCHS and dates back to 1970. The specific ICD-10 codes are O00-O95, O98-O99, O96 (obstetric cause of death more than 42 days but less than 1 year after delivery), and O97 (death from sequelae of direct/indirect obstetric cause occurring 1 year or more after delivery).  

Table 2 below shows Texas maternal death rates within and beyond 42 days following the end of pregnancy, using DSHS CHS data. These rates are regularly presented in the DSHS CHS Vital Statistics Annual Report as the number of maternal deaths per 1,000 live births or per 1,000 female population, but are shown here as number of maternal deaths per 100,000 live births for consistency when compared against Table 1.  

Table 2. Texas Maternal Death Rate within and beyond 42 Days Following End of Pregnancy, 2010-2015  

Year Number of Deaths

Number of

Live Births

Maternal Death Rate
  • (per 100,000 live births)
  • 2015
143 403,439 35.4
  • 2014
139 399,482 34.8
  • 2013
153 387,110 39.5
  • 2012
121 382,438 31.6
  • 2011
116 377,274 30.7
  • 2010
95 385,746 24.6

Data Source: Center for Health Statistics, Texas Department of State Health Services
Definition Source: National Center for Health Statistics, Centers for Disease Control and Prevention  

More reports and information on maternal death in Texas, including the role and work of the Texas Maternal Mortality and Morbidity Task Force, are on the Maternal Mortality and Morbidity homepage.  

References:  

1 MacDorman MF, Declercq E, Thoma ME. Trends in maternal mortality by sociodemographic characteristics and cause of death in 27 states and the District of Columbia. Obstet Gynecol 2017; 129(5):811-818.  

2 Davis NL, Hoyert DL, Goodman DA, Hirai AH, Callaghan WM. Contribution of maternal age and pregnancy checkbox on maternal mortality ratios in the United States, 1978-2012. Am J Obstet Gynecol 2017; doi: 10.1016/j.ajog.2017.04.042. [Epub ahead of print].

 

Last updated December 5, 2017