Hoyert Donna L, Uddin Sayeedha F G, Miniño Arialdi M
Natl Vital Stat Rep. 2020 Jan;69(1):1-25.
Objectives-This report quantifies the impact of the inclusion of a pregnancy status checkbox item on the U.S. Standard Certificate of Death on the number of deaths classified as maternal. Maternal mortality rates calculated with and without using the checkbox information for deaths in 2015 and 2016 are presented. Methods-This report is based on cause-of-death information from 2015 and 2016 death certificates collected through the National Vital Statistics System. Records originally assigned to a specified range of ICD-10 codes (i.e., A34, O00-O99) when using information from the checkbox item were recoded without using the checkbox item. Ratios of deaths assigned as maternal deaths using checkbox item information to deaths assigned without checkbox item information were calculated to quantify the impact of the pregnancy status checkbox item on the classification of maternal deaths for 47 states and the District of Columbia. Maternal mortality rates for all jurisdictions calculated using cause-of-death information entered on the certificate with and without the checkbox were compared overall and by characteristics of the decedent. Results-Use of information from the checkbox, along with information from the cause-of-death section of the certificate, identified 1,527 deaths as maternal compared with 498 without the checkbox in 2015 and 2016 (ratio = 3.07), with the impact varying by characteristics of the decedent such as age at death. The ratio for women under age 25 was 2.15 (204 compared with 95 deaths) but was 14.14 (523 compared with 37 deaths) for women aged 40-54. Without the adoption of the checkbox item, maternal mortality rates in both 2015 and 2016 would have been reported as 8.7 deaths per 100,000 live births compared with 8.9 in 2002. With the checkbox, the maternal mortality rate would be reported as 20.9 and 21.8 deaths per 100,000 live births in 2015 and 2016.
目标——本报告量化了在美国标准死亡证明中加入妊娠状态复选框项目对归类为孕产妇死亡数量的影响。报告呈现了在计算2015年和2016年死亡的孕产妇死亡率时使用和不使用复选框信息的情况。方法——本报告基于通过国家生命统计系统收集的2015年和2016年死亡证明中的死因信息。在使用复选框项目信息时最初被指定为特定范围的ICD - 10编码（即A34、O00 - O99）的记录，在不使用复选框项目的情况下进行了重新编码。计算了使用复选框项目信息归类为孕产妇死亡的数量与不使用复选框项目信息归类为孕产妇死亡的数量之比，以量化妊娠状态复选框项目对47个州和哥伦比亚特区孕产妇死亡分类的影响。总体上以及按死者特征比较了使用证明上填写的死因信息（有复选框和无复选框）计算的所有司法管辖区的孕产妇死亡率。结果——使用复选框信息以及证明死因部分的信息，在2015年和2016年确定了1527例死亡为孕产妇死亡，而不使用复选框时为498例（比率 = 3.07），其影响因死者特征（如死亡年龄）而异。25岁以下女性的比率为2.15（204例死亡与95例死亡相比），但40 - 54岁女性的比率为14.14（523例死亡与37例死亡相比）。如果不采用复选框项目，2015年和2016年的孕产妇死亡率报告均为每10万例活产8.7例死亡，而200年为8.9例。有了复选框，2015年和2016年的孕产妇死亡率报告将分别为每10万例活产20.9例和21.8例死亡。
