Maternal Mortality in the United States: Changes in Coding, Publication, and Data Release, 2018.
Maternal Mortality in the United States: Changes in Coding, Publication, and Data Release, 2018.
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发表时间：
2020-01
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通讯作者：
D. Hoyert;A. Miniño
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作者：
D. Hoyert;A. Miniño
本报告描述了国家卫生统计中心（NCHS）如何编码，发布和发布孕产妇死亡率数据的变化，并使用新的编码方法提供了2018年孕产妇死亡率的官方估计。由于2003年修订的美国标准死亡证明书上的怀孕状态复选框项目的逐步实施，NCHS最后一次公布美国孕产妇死亡率的官方估计是在2007年。截至2018年，所有50个州都完成了修订后的证书的实施，包括其妊娠复选框（注意加州实施了与美国标准死亡证书不同的复选框），允许NCHS恢复孕产妇死亡统计数据的常规发布。然而，对数据质量的评价表明，在采用该复选框后，孕产妇死亡（怀孕42天内死亡）的报告出现了一些错误，包括多报了老年妇女的孕产妇死亡。因此，NCHS采用了一种新的方法（称为2018年方法）对孕产妇死亡进行编码，以减少这些可能的错误。2018年的方法进一步限制了怀孕复选框对10-44岁死者的应用，而之前的年龄组为10-54岁。此外，2018年的方法仅将产妇代码分配给潜在原因，当复选框是死亡证明上唯一的妊娠指示时，并且当死亡原因声明中没有提供其他妊娠信息时，这种编码仅适用于10-44岁的死者。根据新方法，2018年共有658例死亡被确定为孕产妇死亡。2018年的孕产妇死亡率为每10万例活产17.4例死亡，非西班牙裔黑人妇女的死亡率（37.1）是非西班牙裔白色妇女（14.7）和西班牙裔妇女（11.8）的2.5至3.1倍。发病率也随着年龄的增长而增加。在不使用复选框中获得的信息的情况下计算的孕产妇死亡率也列出了2002年，2015年，2016年，2017年和2018年，以便使用所有州的可比编码方法进行比较。
This report describes changes in how the National Center for Health Statistics (NCHS) will code, publish, and release maternal mortality data and presents official 2018 maternal mortality estimates using a new coding method. Due to the incremental implementation of the pregnancy status checkbox item on the 2003 revised U.S. Standard Certificate of Death, NCHS last published an official estimate of the U.S. maternal mortality rate in 2007. As of 2018, implementation of the revised certificate, including its pregnancy checkbox, is complete for all 50 states (noting that California implemented a different checkbox than that on the U.S. Standard Certificate of Death), allowing NCHS to resume the routine publication of maternal mortality statistics. However, an evaluation of data quality indicated some errors with the reporting of maternal deaths (deaths within 42 days of pregnancy) following adoption of the checkbox, including overreporting of maternal deaths among older women. Therefore, NCHS has adopted a new method (to be called the 2018 method) for coding maternal deaths to mitigate these probable errors. The 2018 method involves further restricting application of the pregnancy checkbox to decedents aged 10-44 years from the previous age group of 10-54. In addition, the 2018 method restricts assignment of maternal codes to the underlying cause alone when the checkbox is the only indication of pregnancy on the death certificate, and such coding would be applied only to decedents aged 10-44 based solely on the checkbox when no other pregnancy information is provided in the cause-of-death statement. Based on the new method, a total of 658 deaths were identified in 2018 as maternal deaths. The maternal mortality rate for 2018 was 17.4 deaths per 100,000 live births, and the rate for non-Hispanic black women (37.1) was 2.5 to 3.1 times the rates for non-Hispanic white (14.7) and Hispanic (11.8) women. Rates also increased with age. Maternal mortality rates calculated without using information obtained from the checkbox are also presented for 2002, 2015, 2016, 2017, and 2018 to provide comparisons over time using a comparable coding approach across all states.