The sixth MBRRACE-UK collaboration’s annual report Saving Lives, Improving Mothers’ Care led by the National Perinatal Epidemiology Unit shows that the number of women dying as a consequence of complications during or after pregnancy remains low in the UK - fewer than 10 of every 100,000 pregnant women die in pregnancy or around childbirth.
The report is the latest produced for the Maternal, Newborn and Infant Clinical Outcome Review Programme, run by the MBRRACE-UK collaboration. The authors analysed 2.3m pregnancies from 2015-2017 in the UK and Ireland. During that three year period, 209 women in the UK and Ireland died during their pregnancies or up to six weeks afterwards from pregnancy-related causes. This is equivalent to just over nine women per 100,000.
The leading cause of maternal deaths in the UK is still cardiovascular disease, including heart attacks, heart failure and heart rhythm problems, and there has been no reduction in maternal deaths from heart related causes for more than 15 years.
Of the women who died, 48, or 23%, died from heart disease, while 16% died from blood clots. A further 13% of women’s deaths were caused by epilepsy and stroke. When the deaths were reviewed, the researchers found that many of the women who died from cardiovascular disease had classical symptoms that would have been flagged as relating to heart disease in a non-pregnant person, but instead were put down to their pregnancy. Three quarters of the women who died did not know they had heart disease before they became pregnant.
The authors of the report encourage women to be aware of the risks and symptoms of cardiovascular disease, and to seek help if they have chest pain or a racing heart, and also make healthcare professionals aware if anyone in their family has heart disease, or there is a history of sudden unexplained deaths at a young age (<40yr) in the family.
Other causes of maternal deaths up to six weeks after pregnancy include infection (10%), deaths related to mental health conditions (10%) and cancer (4%). Mental health conditions remain the leading cause of pregnancy-associated deaths between six weeks and a year after giving birth (30%).
The report also found similar racial inequalities to those noted in previous reports. Black women are five times more likely to die as a result of pregnancy than white women. Women with mixed ethnicity are three times as likely to die as white women and Asian women twice as likely to die. Investigations are ongoing to determine the underlying causes of these disparities and how to tackle them.