Donald School Journal of Ultrasound in Obstetrics and Gynecology

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VOLUME 17 , ISSUE 1 ( January-March, 2023 ) > List of Articles

REVIEW ARTICLE

The Ethical Obligation to Prevent Maternal Mortality during the COVID-19 Pandemic and Beyond

Amos Grunebaum, Frank A Chervenak

Keywords : COVID-19, Hemorrhage, Maternal deaths, Mental health, Maternal mortality, Preeclampsia, Thromboembolism, United States

Citation Information : Grunebaum A, Chervenak FA. The Ethical Obligation to Prevent Maternal Mortality during the COVID-19 Pandemic and Beyond. Donald School J Ultrasound Obstet Gynecol 2023; 17 (1):67-70.

DOI: 10.5005/jp-journals-10009-1961

License: CC BY-NC 4.0

Published Online: 14-04-2023

Copyright Statement:  Copyright © 2023; The Author(s).


Abstract

The United States of America (USA) has the highest maternal mortality rate of all high-income countries, with over 80% found to be preventable. After leveling off around 2015, maternal mortality rates in the USA further increased due to coronavirus disease 2019 (COVID-19) related deaths starting in 2020 by about 20% from about 17–18/100,000 live births to about 24/100,000 live births with about one in seven maternal deaths due to COVID-19 infections. The vast majority of COVID-19-related maternal deaths were among unvaccinated pregnant patients. A total of 11% of postpartum maternal deaths were found to be associated with mental health issues, with the remainder usually due to medical issues such as hemorrhage and hypertension. As physicians, we have the ethical obligation to address perinatal and maternal mortality, especially preventable maternal mortalities, reduce the discrepancy between different races and ethnicities, recommend COVID-19 vaccinations, and develop approaches to address the causes.

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  1. The U.S. Maternal Mortality Crisis Continues to Worsen: An International Comparison. https://www.commonwealthfund.org/blog/2022/us-maternal-mortality-crisis-continues-worsen-international-comparison. Accessed 1/7/2023.
  2. https://www.cdc.gov/media/releases/2022/p0919-pregnancy-related-deaths.html
  3. Heron M. Deaths: leading causes for 2017. Natl Vital Stat Rep 2019;68(6):1–77. PMID: 32501203.
  4. Maternal Health: Outcomes Worsened and Disparities Persisted During the Pandemic https://www.gao.gov/products/gao-23-105871. Accessed 1/7/2023.
  5. https://www.cdc.gov/reproductivehealth/maternal-mortality/pregnancy-mortality-surveillance-system.htm
  6. Kuklina EV, Ayala C, Callaghan WM. Hypertensive disorders and severe obstetric morbidity in the United States. Obstet Gynecol 2009;113(6):1299–1306. DOI: 10.1097/AOG.0b013e3181a45b25
  7. Albrecht SS, Kuklina EV, Bansil P, et al. Diabetes trends among delivery hospitalizations in the US, 1994–2004. Diabetes Care 2010;33(4):768–773. DOI: 10.2337/dc09-1801
  8. Correa A, Bardenheier B, Elixhauser A, et al. Trends in prevalence of diabetes among delivery hospitalizations, United States, 1993–2009. Matern Child Health J 2015;19(3):635–642. DOI: 10.1007/s10995-014-1553-5
  9. Kuklina E, Callaghan W. Chronic heart disease and severe obstetric morbidity among hospitalisations for pregnancy in the USA: 1995–2006. BJOG 2011;118(3):345–352. DOI: 10.1111/j.1471-0528.2010.02743.x
  10. Creanga AA, Syverson C, Seed K, et al. Pregnancy-related mortality in the United States, 2011–2013. Obstet Gynecol 2017;130(2):366–373. DOI: 10.1097/AOG.0000000000002114
  11. McCullough LB, Coverdale JH, Chervenak FA. Professional ethics in obstetrics and gynecology. Cambridge and New York: Cambridge University Press, 2020.
  12. Chervenak FA, McCullough LB. The Professional Responsibility Model of Perinatal Ethics. Berlin: Walter de Gruyter, 2014.
  13. Chervenak FA, McCullough LB, Brent RL. The professional responsibility model of obstetrical ethics: avoiding the perils of clashing rights. Am J Obstet Gynecol 2011;205(4):315.e1–315.e5. DOI: 10.1016/j.ajog.2011.06.006
  14. https://safehealthcareforeverywoman.org/aim-program/
  15. Trost SL, Beauregard JL, Smoots AN, et al. Preventing pregnancy-related mental health deaths: insights from 14 US maternal mortality review committees, 2008–17. Health Aff (Millwood) 2021;40(10):1551–1559. DOI: 10.1377/hlthaff.2021.00615
  16. Valdes EG, Sparkman L, Aamar R, et al. Improving maternal mental health: assessing the extent of screening and training about peripartum depression. J Matern Fetal Neonatal Med 2023;36(1). DOI: 10.1080/14767058.2022.2155042
  17. Grunebaum A, Pollet SL, Stein RA, et al. Increased pregnancy-related death and disease: a neglected aspect of restricting abortions. Int J Gynaecol Obstet 2022;160(2):709–710. DOI: 10.1002/ijgo.14487
  18. Chervenak FA, McCullough LB, Bornstein E, et al. Professionally responsible coronavirus disease 2019 vaccination counseling of obstetrical and gynecologic patients. Am J Obstet Gynecol 2021;224(5):470–478. DOI: 10.1016/j.ajog.2021.01.027
  19. Chervenak FA, McCullough LB, Grünebaum A. Reversing physician hesitancy to recommend COVID-19 vaccination for pregnant patients. Am J Obstet Gynecol 2022;226(6):805–812. DOI: 10.1016/j.ajog.2021.11.017
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