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More Minority Women Die in Childbirth

Black, Hispanic and Asian women - and a handful of white women not born in the  U.S. - accounted for 41 percent of all births nationwide between 1993 and 2006,  but for 62 percent of pregnancy-related deaths, researchers found.

"Everyone thinks the U.S. has great healthcare, which is definitely the case,  but certainly there are populations in the U.S. that have outcomes that really  look like outcomes in developing countries," said Dr. Allison Bryant, a maternal  fetal medicine specialist from Massachusetts General Hospital in Boston who  wasn't involved in the new study.

She said some of those differences may be due to minority women's lack of  access to good pregnancy care - but that health problems growing up and before  they become pregnant are likely to blame as well.

"If women are dying in the context of pregnancy, it speaks to a much broader  problem in terms of disparities in medicine," Bryant told Reuters Health.

"If everyone had access to good pre-conception care... that might help to  mitigate some of the things that we're seeing on the back end in terms of  pregnancy."

Dr. Andreea Creanga and her colleagues used data collected by the CDC on all  women who died during or within a year after pregnancy as well as birth records  for their babies.

They found that for every 100,000 babies born to white women, between seven  and nine moms died from complications related to pregnancy - including heart  problems, infections and bleeding.

In comparison, 32 to 35 black women died for every 100,000 live babies.  Deaths among Hispanic and Asian women - born in the U.S. and abroad - were  closer to rates for white women at around 10 per 100,000.

Overall, older women were most likely to die during childbirth. Eighteen  white mothers ages 35 and up died for every 100,000 babies born, as did 99 older  black women - almost one for every 1,000 babies.

Consistent with recent research, Creanga's team also found a general increase  in the number of pregnancy-related deaths, from 11 per 100,000 births in 1993 to  almost 16 per 100,000 in 2006. It's not clear whether that rise reflects more  women actually dying or just better identification of the women who do die from  pregnancy-related complications, the researchers reported in Obstetrics &  Gynecology.

They didn't have access to clinical details such as how babies were delivered  and mothers' weight, both of which could affect pregnancy risks.

A total of about 7,500 women died of pregnancy-related complications during  the 14 year-period.

Heart problems and general cardiovascular disease, including high blood  pressure, were the most common causes of death in childbirth for both white and  black women during the latter half of the study period.

"Similar changes have been observed in other countries, and very likely are  due to combination of factors, including postponement of pregnancy and higher  proportions of obesity, diabetes and hypertension among pregnant women," Creanga  told Reuters Health.

Bryant said it's possible some differences in heart-related deaths are due to  genetic or dietary differences between women. Deaths related to bleeding during  childbirth, however, should be preventable with good medical care, she  added.

More research will be needed to see what's really driving these disparities -  and to figure out how to start addressing them, according to Bryant.

The study is published in journal Obstetrics & Gynecology.

Source: Medical Daily at http://www.medicaldaily.com/articles/11304/20120804/minority-women-death-childbirth.htm#QLugE8SApJFkkBwZ.99

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