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Report: Maternal Deaths on Rise in U.S.

America falls behind most high-income countries

The U.S. is among eight countries in the world to experience an increase in maternal mortality since 2003 — joining Afghanistan and countries in Africa and Central America, according to a new study by the Institute for Health Metrics and Evaluation at the University of Washington.

The study, published May 2 in The Lancet, ranked the U.S. number 60 in the list of 180 countries on maternal deaths, compared with its rank of 22 in 1990. In contrast, China rose to number 57, up from number 116 in 1990.

In the U.S., 18.5 mothers died for every 100,000 live births in 2013 — more than double the figures for maternal mortality in Saudi Arabia (7.0) and Canada (8.2), and more than triple those in the U.K. (6.1).

The biggest increase in maternal mortality by age group occurred in women 20 to 24 years of age. In 1990, 7.2 women in this age group died for every 100,000 live births, and in 2013, 14.0 died for every 100,000 live births.

The study focused on measuring trends in maternal mortality, but the researchers offer possible explanations for the disparities between the U.S. and other countries, including the lack of access to prenatal care and other health services, high rates of caesarian-section deliveries, and pregnancies complicated by obesity, diabetes, and other conditions.

A separate study, also published May 2 in The Lancet, examined child survival rates and found that 28,000 children under the age of 5 years died in the U.S. in 2013. Child death rates in the U.S. declined throughout 1990–2013, but the pace of the declines has slowed. During the 1990s, child mortality declined 3.2% annually, and after 2000, the rate slowed to 1.7%.

The study also found that child death rates dropped by 48% globally between 1990 and 2013. However, 6.3 million children still died before their fifth birthday in 2013. Most countries have seen faster declines in child deaths — with these deaths declining by 3.5% per year since 2000.

According to the authors, the findings show that maternal education and income growth have had a significant effect in reducing child deaths. In addition, there was a strong trend in rich and poor countries that appeared to be related to technological and other advances, such as vaccine and drug innovations.

Source: EurekAlert; May 2, 2014.

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