Position Statement on a health Indicator: Maternal Mortality Rate
***ASSIGNMENT: After reading the topics and text for this module, provide a position statement on a health indicator of your choice for a specific population.
(REMEMBER ALL OF THESE INFORMATION PROVIDED HERE IS STRAIGH FROM THE TEXBOOK, WEBSITES OR ARTICLES, SO IT MUST BE PARAPHRASED) Include all of these main points in this paper please.
-According to Merrill (2017), epidemiology uses several indicators to identify the health status of populations
- Discuss what is a health indicator: “is a marker of health status (physical or mental disease, impairment or disability, and social well-being), service provision, or resource availability” (Merrill, 2017)
The indicators are used to assess the health of the Nation, facilitate collaboration across sectors, and motivate action at the national, state, and community levels to improve the health of the U.S. population. https://www.healthypeople.gov/2020/Leading-Health-Indicators
- One example of health indicator is the maternal mortality rate which helps epidemiologists to understand the problem and create ways to intervene and improve the situation.
- DISCUSS ABOUT MATERNAL Mortality Rate
- So discuss what are the causes/risks that increase Maternal Mortality Rate?
-Maternal mortality: A pregnancy-related death is defined as the death of a woman while pregnant or within 1 year of the end of a pregnancy –regardless of the outcome, duration or site of the pregnancy–from any cause related to or aggravated by the pregnancy or its management, but not from accidental or incidental causes. CDC, 2019. Reproductive Health. https://www.cdc.gov/reproductivehealth/maternalinfanthealth/pregnancy-mortality-surveillance-system.htm?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Freproductivehealth%2Fmaternalinfanthealth%2Fpmss.html
“Maternal mortality is a key indicator of a health system’s strength”
- statistics: “about 700 women die each year in the United States as a result of pregnancy or delivery complications”. CDC, 2019. Reproductive Health. Retrieved from: https://www.cdc.gov/reproductivehealth/maternalinfanthealth/pregnancy-relatedmortality.htm
The pregnancy-related mortality ratio is an estimate of the number of pregnancy-related deaths for every 100,000 live births. This ratio is often used as an indicator to measure the nation’s health. Factors that affect the health of the entire population can also affect mortality among pregnant and postpartum women.
The pregnancy-related mortality ratio fell significantly in the United States during the 20th century. This historic decline was because of medical and technological advances. Interest and concern at the local, state, and federal levels for why pregnancy-related deaths occur led to the development of systems for identifying, reviewing, and analyzing pregnancy-related deaths.
Since the Pregnancy Mortality Surveillance System was implemented, the number of reported pregnancy-related deaths in the United States steadily increased from 7.2 deaths per 100,000 live births in 1987 to 18.0 deaths per 100,000 live births in 2014. The reasons for the overall increase in pregnancy-related mortality are unclear. Many studies show that an increasing number of pregnant women in the United States have chronic health conditions such as hypertension,2 diabetes,3 and chronic heart disease.
In the United States
Of the 7,208 deaths within a year of the end of pregnancy that occurred during 2011–2014 and were reported to CDC, 2,726 were found to be pregnancy-related. The pregnancy-related mortality ratios were 17.8, 15.9, 17.3, and 18.0 deaths per 100,000 live births in 2011, 2012, 2013, and 2014, respectively.
(THIS IS OUR POSITION STATEMENT): The major cause of maternal mortality rate in the United states is cardiovascular disease. According to the CDC (2019), The highest percentages of pregnancy-related deaths in the United States during 2011–2014 was caused by Cardiovascular diseases, 15.2%.
CDC, 2019. Reproductive Health. https://www.cdc.gov/reproductivehealth/maternalinfanthealth/pregnancy-mortality-surveillance-system.htm?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Freproductivehealth%2Fmaternalinfanthealth%2Fpmss.html
Maternal morbidity and mortality in the United States continues to be high. A review of obstetric anesthesia malpractice claims filed against nurse anesthetists (N = 21), extracted from the American Association of Nurse Anesthetists Foundation Closed Claims database, was completed. The malpractice claims included 18 maternal claims and 3 neonatal claims. The most common adverse maternal outcomes were maternal death (8/18) and nerve injury (4/18). Hemorrhage accounted for the greatest number of maternal deaths (3/8) followed by cardiovascular failure, emboli, and neuraxial opioid overdose (Clayton, 2018)article.
- The US maternal mortality ratio (estimated number of maternal deaths/100,000 births) doubled between 1987 and 2013. Cardiovascular conditions are the leading cause of maternal death, followed by infection, hemorrhage embolism, and hypertension, with some deaths being preventable. (Clayton, 2018).
- Myocardial infarction (MI) is a major cause of morbidity and mortality for pregnant and postpartum women. A recent review of cause-specific maternal mortality in Canada showed coronary artery disease to be the leading etiology. Studies conducted in the USA reported the highest rates of maternal mortality due to pregnancy-associated MI (0.28/100 000 pregnancies), while studies done in Canada (0.06/100 000 pregnancies) and Europe (0.19/ 100 000 pregnancies) reported lower rates. (Gibson, 2017)
Cardiovascular disease (CVD), defined as coronary death, myocardial infarction, coronary insufficiency, angina, ischemic stroke, hemorrhagic stroke, transient ischemic attack, peripheral artery disease, and heart failure, is the leading global cause of death, accounting for over 30 percent of all deaths worldwide– 17.3 million deaths per year. Associations have long been established between CVD and a wide variety of risk factors, including non-modifiable variables such as age, sex, and family history, and modifiable atherosclerotic risk factors, such as cigarette smoking, alcohol intake, increased BMI, systolic blood pressure (SBP), diabetes mellitus, high-density lipoprotein (HDL) level, and hypercholesterolemia. For example, shared environmental risk factors, such as the presence of smoke and unhealthful diet, accounts for some of the increased risk of CVD. (Allport 2016).
Heart disease (HD) is the most common cause of death among pregnant women in the United States and other developed nations.1-3 Pregnancy is accompanied by increases in total body fluid and circulating blood volume, as well as marked increases in cardiac output, often placing considerable demands on the maternal cardiovascular system of women with underlying HD. Women with cardiovascular diseases often cannot optimally adapt to thehemodynamic challenges of pregnancy, increasing their risk for complications, particularly during labor and delivery when hemodynamic demands are at their highest. (Lima,2017).
**Cardiovascular disease most common pregnancy complications (ie, pre-eclampsia, gestational diabetes, and hypertension). Cardiovascular disease (CVD) continues to be the leading cause of death in women. *recommendations emphasize monitoring and treatment of major CVD risk factors in women, specially those of reproductive age (ie, hypertension, obesity, smoking, and dyslipidemia). -It is important to Assessing Risk Factors for Cardiovascular Disease Risk in Women(specially those women of reproductive age) and provide education and treatment in order to reduce maternity mortality rate. Cardiovascular disease has multifactorial etiology such as genetic predisposition. Some modifiable Risk factors for cardiovascular disease include: smoking, HTN, obesity & dyslipidemia. (ANDERSEN, 2017)
- Studies have shown how lifestyle factors contribute to cardiovascular disease, such as diet, exercise, stress, smoking (Ryan 2018)
-evidence suggests that maintaining a healthy lifestyle throughout young adulthood is strongly associated with a low risk profile in middle age (6) . Primordial prevention, defined as prevention of the development of clinical risk factors (7) , through maintenance or adoption of a healthy lifestyle will sustain women in a low CVD risk profile and, consequently, reduce their incidence of CHD (1) . Furthermore, it could reduce the substantial economic burden of the medical management of intermediate CVD-related conditions, as hypertension, diabetes mellitus, and hyperlipidemia are among the top 10 leading diagnoses for direct health expenditures in the United States (Chomistek, 2015)
- Health care provider are responsible to assess for risk factors for CVD and plan interventions to decrease the maternal mortality rate
