Why African-American women are at greater risk for pregnancy-related death

UMMS Affiliation

Meyers Primary Care Institute; Department of Medicine, Division of Geriatric Medicine

Publication Date


Document Type



Adult; African Americans; Comorbidity; Female; Health Behavior; *Health Status; Humans; *Maternal Mortality; Pregnancy; Pregnancy Complications; Prenatal Care


Health Services Research | Primary Care


PURPOSE: Our study aim was to identify factors that may contribute to the racial disparity in pregnancy-related mortality.

METHODS: We examined differences in severity of disease, comorbidities, and receipt of care among 608 (304 African-American and 304 white) consecutive patients of non-Hispanic ethnicity with one of three pregnancy-related morbidities (pregnancy-related hypertension, puerperal infection, and hemorrhage) from hospitals selected at random from a statewide region.

RESULTS: African-American women had more severe hypertension, lower hemoglobin concentrations preceding hemorrhage, more antepartum hospital admissions, and a higher rate of obesity. The rate of surgical intervention for hemorrhage was lower among African-Americans, although the severity of hemorrhage did not differ between the two racial groups. More African-American women received eclampsia prophylaxis. After stratifying by severity of hypertension, we found that more African-Americans received antihypertensive therapy. The rate of enrollment for prenatal care was lower in the African-American group. Among women receiving prenatal care, African-American women enrolled significantly later in their pregnancies.

CONCLUSIONS: We have identified racial differences in severity of disease, comorbidities, and care status among women with pregnancy-related complications that would place African-Americans at disadvantage to survive pregnancy. These differences are potentially modifiable.

DOI of Published Version



Ann Epidemiol. 2007 Mar;17(3):180-5. Link to article on publisher's site

Journal/Book/Conference Title

Annals of epidemiology


At the time of publication, Elizabeth Dugan was not yet affiliated with the University of Massachusetts Medical School.

Related Resources

Link to Article in PubMed

PubMed ID