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Maternal mortality rates in the UK have reached levels not witnessed since 2003-05.
According to a collaborative investigation led by MBRRACE-UK (Mothers and Babies: Reducing Risk Through Audits and Confidential Enquiries), the maternal death rate during or shortly after pregnancy stood at 13.41 deaths per 100,000 maternities (95% CI, 11.86-15.10) in the period 2020-22.
This figure represents a significant rise compared with the 8.79 deaths per 100,000 (95% CI, 7.58-10.12) recorded in 2017-19, and mirrors the 13.95 rate observed in 2003-05.
If deaths attributable to COVID-19 are excluded, the maternal mortality rate for 2020-22 remains high at 11.54 per 100,000 maternities, surpassing the rate for 2019-21 (10.06) but not reaching significance.
Thrombosis and thromboembolism emerged as the leading causes of maternal death during pregnancy or within 6 weeks of pregnancy ending. COVID-19 ranked as the second most common cause, albeit with lower rates than in 2019-21. From 2021 to 2022, there was a significant reduction in the maternal mortality rate attributable to COVID-19.
Suicide and sepsis due to pregnancy-related infections were the next most common direct causes of maternal death, each responsible for an equal number of fatalities. Beyond COVID-19, cardiac disease and neurological conditions ranked as the leading indirect causes of maternal deaths in the 2020-22 period.
The report also underscored significant disparities in maternal mortality rates based on ethnicity and socioeconomic factors. Women from Black ethnic minority backgrounds faced a significant threefold increase in the risk of maternal death compared with White women. Although the mortality rate for Black women is lower than in 2019-21, the difference is not significant.
Similarly, women from Asian backgrounds continued to be at a 67% higher risk than White women. The mortality rate for women from Asian ethnic backgrounds is higher, although not significantly, than the rate in 2019-21.
The socioeconomic gap persists, revealing that women residing in the 20% most deprived areas have maternal mortality rates more than twice as high as those living in the 20% least deprived areas.
These alarming statistics emphasize the critical need for a closer examination of healthcare practices and policies surrounding maternal care.
“The 2023 MBRRACE-UK maternal confidential enquiry report identified clear examples of maternity systems under pressure, and this increase in maternal mortality raises further concern,” noted Professor Marian Knight, director of the National Perinatal Epidemiology Unit (NPEU) and maternal reporting lead for MBRRACE-UK on the NPEU website.
“Ensuring pre-pregnancy health, including tackling conditions such as overweight and obesity, as well as critical actions to work towards more inclusive and personalised care, needs to be prioritised as a matter of urgency now more than ever,” she added.
