Maternal mortality in the Mississippi Delta region.

Abstract

To compare the maternal mortality rate (MMR) in the Mississippi Delta region of the United States with that of the non-Delta region states. Analyzed data come from national birth certificate and death certificate data for 1999-2007. Data were aggregated for analysis by region, counties of the Delta Regional Authority, non-Delta regions of the eight Delta states, and the 42 non-Delta states. The MMR was calculated using birth data as the denominator and maternal mortality data as the numerator. During the 9 years of the study, there were more than 36 million births in the United States and 5002 reported maternal deaths. The national MMR was 13.5/100,000 (95% confidence interval [CI] 13.1-13.9/100,000). The MMR reported in the non-Delta states was 13.6/100,000 (95% CI 13.2-14.0/100,000); in the non-Delta counties of the Delta states, the MMR was 13.1/100,000 (95% CI 12.1-14.0/100,000); and the MMR was 18.5/100,000 (95% CI 16.1-20.9/100,000) in Delta counties. The odds of maternal death in Delta counties is 1.39 times (95% CI 1.22-1.59) higher compared with non-Delta counties or non-Delta states. There was no statistically significant difference between the MMR in non-Delta states and the MMR in non-Delta counties of Delta states. After controlling for maternal race/ethnicity, age, marital status, and education in a multivariable model, the MMR in the Delta counties compared with non-Delta counties and non-Delta states remains significantly increased (odds ratio 1.16, 95% CI 1.01-1.32). Overall, maternal mortality is significantly greater in the Delta region of the United States compared with the non-Delta portion. After controlling for maternal race/ethnicity, age, marital status, and education, the odds of maternal death remains 16% higher in the Delta region of the United States compared with the non-Delta United States.