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Maternal Mortality in Missouri: A Comparison of Definitions and Data Sources.
Daniel J Quay1, Karen Harbert, Wayne Schramm
1Author Affiliations: Office of Epidemiology, Missouri Department of Health and Senior Services, Jefferson City, Missouri (Mr Quay, Ms Harbert, and Dr Garikapaty); and Bureau of Health Care Analysis and Data Dissemination, Missouri Department of Health and Senior Services, Jefferson City, Missouri (Mr Schramm).
Journal of Public Health Management and Practice : JPHMP
|January 14, 2025
Summary
Missouri
Area of Science:
- Public Health
- Epidemiology
- Maternal Health Surveillance
Background:
- Multiple surveillance systems address maternal mortality in Missouri.
- These systems exhibit significant methodological variations in definitions, criteria, and purpose.
- Understanding these differences is crucial for accurate data interpretation and policy development.
Purpose of the Study:
- To analyze the practical implications of methodological differences across Missouri's maternal mortality surveillance systems.
- To assess how variations in case inclusion criteria affect data interpretation and policy decisions.
- To compare data from Missouri Vital Statistics, Pregnancy Mortality Surveillance System, and Pregnancy-Associated Mortality Review (PAMR).
Main Methods:
- Comparative analysis of death certificates from key Missouri surveillance programs.
- Identification and documentation of commonalities and discrepancies in data collection and definitions.
- Focus on the inclusion criteria for pregnancy-related deaths, particularly concerning injury-related fatalities.
Main Results:
- Significant methodological differences exist between surveillance systems, impacting case counts.
- The Pregnancy-Associated Mortality Review (PAMR) program uniquely includes injury deaths in pregnancy-related mortality data.
- These discrepancies can lead to divergent conclusions regarding maternal mortality trends.
Conclusions:
- Methodological variations in maternal mortality surveillance systems have tangible effects on data.
- Awareness of these differences is essential for accurate analysis and informed policy-making.
- The inclusion of injury deaths by PAMR highlights a critical distinction in surveillance approaches.
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