355: A Comparison of the Causes of Maternal Deaths in Urban Versus Rural Georgia

ObjectiveTo describe the causes of pregnancy related and pregnancy associated deaths in rural and urban areas of Georgia.Study DesignA retrospective review of pregnancy associated (PA) deaths in Georgia in 2010 and 2012 was conducted. PA deaths occured during or within one year of pregnancy from any cause. Pregnancy related (PR) deaths resulted from either a direct or indirect complication of pregnancy. Each PA death was categorized as either PR; due to medical condition; suicide; overdose; homicide; or MVA. PR deaths were subdivided into cardiomyopathies, hypertensive disorders, hemorrhage, infection, VTE, amniotic fluid embolism, other cardiac causes, CVA, other non-cardiovascular causes, and unknown. We compared causes of PA and PR deaths in rural and urban areas.ResultsIn total, 163 PA deaths were identified in Georgia in 2010 and 2012. Of these, 59 were PR; 34 were due to other medical conditions; 13 were due to suicide; 17 were due to overdose; 19 were due to homicide; and 21 were due to MVA. The overall PR mortality ratio (PRMR) for 2010 and 2012 in Georgia was 22.4/100,000 live births. Of the 59 PR deaths, the largest proportion was due to cardiomyopathy (17%). The PRMR in rural areas was 21.1 and in non-rural areas was 22.6. The percent of PA deaths due to suicide was 15% in rural areas, compared to 8% and 4% in urban non-metropolitan and metropolitan Atlanta areas, respectively.ConclusionPR deaths represented the largest proportion of PA deaths. There was no difference between rural and non-rural PRMR. The high rates of deaths due to cardiomyopathy shed light on the need for early detection and intervention for peripartum cardiomyopathy, as these are often preventable deaths. We observed a higher proportion of maternal deaths due to suicide in rural compared to non-rural areas. This reflects the need for improved access to psychiatric services for women of reproductive age in these areas. This analysis highlights the most common causes of maternal death in Georgia and the need for increased access to medical services. ObjectiveTo describe the causes of pregnancy related and pregnancy associated deaths in rural and urban areas of Georgia. To describe the causes of pregnancy related and pregnancy associated deaths in rural and urban areas of Georgia. Study DesignA retrospective review of pregnancy associated (PA) deaths in Georgia in 2010 and 2012 was conducted. PA deaths occured during or within one year of pregnancy from any cause. Pregnancy related (PR) deaths resulted from either a direct or indirect complication of pregnancy. Each PA death was categorized as either PR; due to medical condition; suicide; overdose; homicide; or MVA. PR deaths were subdivided into cardiomyopathies, hypertensive disorders, hemorrhage, infection, VTE, amniotic fluid embolism, other cardiac causes, CVA, other non-cardiovascular causes, and unknown. We compared causes of PA and PR deaths in rural and urban areas. A retrospective review of pregnancy associated (PA) deaths in Georgia in 2010 and 2012 was conducted. PA deaths occured during or within one year of pregnancy from any cause. Pregnancy related (PR) deaths resulted from either a direct or indirect complication of pregnancy. Each PA death was categorized as either PR; due to medical condition; suicide; overdose; homicide; or MVA. PR deaths were subdivided into cardiomyopathies, hypertensive disorders, hemorrhage, infection, VTE, amniotic fluid embolism, other cardiac causes, CVA, other non-cardiovascular causes, and unknown. We compared causes of PA and PR deaths in rural and urban areas. ResultsIn total, 163 PA deaths were identified in Georgia in 2010 and 2012. Of these, 59 were PR; 34 were due to other medical conditions; 13 were due to suicide; 17 were due to overdose; 19 were due to homicide; and 21 were due to MVA. The overall PR mortality ratio (PRMR) for 2010 and 2012 in Georgia was 22.4/100,000 live births. Of the 59 PR deaths, the largest proportion was due to cardiomyopathy (17%). The PRMR in rural areas was 21.1 and in non-rural areas was 22.6. The percent of PA deaths due to suicide was 15% in rural areas, compared to 8% and 4% in urban non-metropolitan and metropolitan Atlanta areas, respectively. In total, 163 PA deaths were identified in Georgia in 2010 and 2012. Of these, 59 were PR; 34 were due to other medical conditions; 13 were due to suicide; 17 were due to overdose; 19 were due to homicide; and 21 were due to MVA. The overall PR mortality ratio (PRMR) for 2010 and 2012 in Georgia was 22.4/100,000 live births. Of the 59 PR deaths, the largest proportion was due to cardiomyopathy (17%). The PRMR in rural areas was 21.1 and in non-rural areas was 22.6. The percent of PA deaths due to suicide was 15% in rural areas, compared to 8% and 4% in urban non-metropolitan and metropolitan Atlanta areas, respectively. ConclusionPR deaths represented the largest proportion of PA deaths. There was no difference between rural and non-rural PRMR. The high rates of deaths due to cardiomyopathy shed light on the need for early detection and intervention for peripartum cardiomyopathy, as these are often preventable deaths. We observed a higher proportion of maternal deaths due to suicide in rural compared to non-rural areas. This reflects the need for improved access to psychiatric services for women of reproductive age in these areas. This analysis highlights the most common causes of maternal death in Georgia and the need for increased access to medical services. PR deaths represented the largest proportion of PA deaths. There was no difference between rural and non-rural PRMR. The high rates of deaths due to cardiomyopathy shed light on the need for early detection and intervention for peripartum cardiomyopathy, as these are often preventable deaths. We observed a higher proportion of maternal deaths due to suicide in rural compared to non-rural areas. This reflects the need for improved access to psychiatric services for women of reproductive age in these areas. This analysis highlights the most common causes of maternal death in Georgia and the need for increased access to medical services.