Social Determinants of Pregnancy-related Mortality and Morbidity in the United States: A Systematic Review

Abstract

(Obstet Gynecol. 2020;135:896–915) The United States has one of the highest maternal mortality rates among high-income countries. This rate, along with maternal morbidity in the United States, has been rising. While health factors such as increased obesity and chronic disease, older maternal age, and high cesarean rates may contribute to maternal mortality and morbidity, social determinants of health are also a contributor. Social determinants of health include environmental conditions and socioeconomic factors like income, education, occupation, race and ethnicity, and sex. Previous studies have examined social determinants of health in relation to neonatal or birth outcomes, but there has been little research on the relationship between social determinants of health and maternal outcomes in the United States. This systematic review aimed to examine social determinants of maternal mortality and morbidity in the United States while identifying areas for future research and action.