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<p>Maternal and perinatal mortality remain critical indicators of health system performance, and the United States continues to report rates that surpass those of comparable high-income countries despite its high healthcare spending. Comparisons across nations are complicated by differing definitions: US surveillance extends monitoring to 365&#xa0;days postpartum and includes deaths from mental health conditions, overdose, and homicide, while international agencies generally restrict reporting to 42&#xa0;days and exclude external causes. Leading contributors to maternal mortality include obstetric complications, cardiovascular disease, and mental health conditions, while perinatal mortality is driven by prematurity, placental and cord pathology, congenital anomalies, and infections. Profound inequities persist, with Black women and other minority populations experiencing rates two to three times higher than White women—disparities not completely explained by socioeconomic status alone but rather rooted in structural racism, systemic barriers, and uneven distribution of quality maternity care. Recent abortion restrictions and limited postpartum coverage have exacerbated risks, particularly in low-income and rural populations. Most maternal and perinatal deaths are considered potentially preventable with timely recognition of complications, standardized protocols, equitable access to care, extended postpartum follow-up, and universal insurance coverage. Addressing these challenges requires sustained commitment across clinical, policy, and societal domains.</p>

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Maternal and perinatal mortality in the United States: an update

  • 期刊论文

  • 发表日期：

    2025年12月20日

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  • Amos Grünebaum,
  • Frank A. Chervenak

摘要

Maternal and perinatal mortality remain critical indicators of health system performance, and the United States continues to report rates that surpass those of comparable high-income countries despite its high healthcare spending. Comparisons across nations are complicated by differing definitions: US surveillance extends monitoring to 365 days postpartum and includes deaths from mental health conditions, overdose, and homicide, while international agencies generally restrict reporting to 42 days and exclude external causes. Leading contributors to maternal mortality include obstetric complications, cardiovascular disease, and mental health conditions, while perinatal mortality is driven by prematurity, placental and cord pathology, congenital anomalies, and infections. Profound inequities persist, with Black women and other minority populations experiencing rates two to three times higher than White women—disparities not completely explained by socioeconomic status alone but rather rooted in structural racism, systemic barriers, and uneven distribution of quality maternity care. Recent abortion restrictions and limited postpartum coverage have exacerbated risks, particularly in low-income and rural populations. Most maternal and perinatal deaths are considered potentially preventable with timely recognition of complications, standardized protocols, equitable access to care, extended postpartum follow-up, and universal insurance coverage. Addressing these challenges requires sustained commitment across clinical, policy, and societal domains.