{"id":245,"date":"2016-04-22T21:07:03","date_gmt":"2016-04-22T21:07:03","guid":{"rendered":"https:\/\/www.vdh.virginia.gov\/medical-examiner\/?page_id=245"},"modified":"2025-07-14T15:04:27","modified_gmt":"2025-07-14T15:04:27","slug":"virginia-pregnancy-associated-mortality-surveillance-system-pamss","status":"publish","type":"page","link":"https:\/\/www.vdh.virginia.gov\/medical-examiner\/division-of-death-prevention\/virginia-pregnancy-associated-mortality-surveillance-system-pamss\/","title":{"rendered":"Virginia Pregnancy-Associated Mortality Surveillance System (PAMSS)"},"content":{"rendered":"
\n

Reports<\/a> | Resources<\/a><\/p>\n

Introduction<\/h2>\n

\"pregnantwoman\"The historical decline of maternal death in the United States during the 20th century is hailed as a remarkable public health achievement.\u00a0 The maternal mortality rate steadily dropped from approximately 850 maternal deaths per 100,000 live births in 1900 to approximately 7.5 deaths in 1982.\u00a0 Advances in medical technology have been credited with spurring this decline. Since 1982, however, no further declines in maternal mortality have been recorded.\u00a0 In 1987, the CDC established the National Pregnancy Mortality Surveillance System to compile and analyze data for epidemiologic studies of maternal deaths in the United States so that prevention strategies could be developed to address the plateau in these rates.\u00a0 A summary of maternal deaths in Virginia between 1981 and 1991 showed a trend similar to that found across the United States.\u00a0 In 1981, Virginia had 21 maternal deaths with a range from 4 to 14 in the following ten years. The number of maternal deaths has continued to increase since.<\/p>\n

The Health People 2030 initiative has set a target to reduce the maternal mortality rate to 15.7 deaths per 100,000 live births, aiming for a 10% improvement from the 2018 baseline of 17.4 deaths per 100,000 live births. Despite these efforts, recent data indicate that maternal mortality rates have worsened, with 22.3 maternal deaths per 100,000 live births reported in 2022. This underscores the need for continued attention and intervention to address the increasing rates.<\/p>\n

Definitions<\/h2>\n

Several definitions are used to describe deaths of women surrounding pregnancy.\u00a0 Maternal mortality<\/em> is defined using the International Classification of Diseases (ICD) as \u201cthe death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy, from any cause related to or aggravated by pregnancy or its management but not from accidental or incidental causes.\u201d 1<\/a> This definition is currently used by the Centers for Disease Control and Prevention\u2019s (CDC\u2019s) National Center for Health Statistics in its publications of maternal mortality statistics in the United States.<\/p>\n

The American College of Obstetricians and Gynecologists (ACOG) and CDC\u2019s Maternal Mortality Study Group developed new terms in 1986 to broaden the definition of maternal mortality.\u00a0 The purpose of the new definitions was to expand the group under study to better define the incidence and describe the causes of death that occur during or near a pregnancy.\u00a0 These new terms are:\u00a0 pregnancy-associated death<\/em> and pregnancy-related death<\/em>.\u00a0 Apregnancy-associated death<\/em> is defined as the death of a woman while pregnant or within one year of the termination of a pregnancy irrespective of the cause of death or the outcome of the pregnancy. 2 <\/a>\u00a0 This term refers to the temporal relationship between the pregnancy and the death.\u00a0 A pregnancy-related death<\/em> is any pregnancy-associated death resulting from one or more of the following:\u00a0 complications of the pregnancy itself; the chain of events initiated by the pregnancy that led to death; or aggravation of an unrelated condition by physiological effects of the pregnancy that subsequently caused death. 3<\/a><\/p>\n

Virginia PAMSS Case Ascertainment<\/h2>\n

In 2002, the Virginia Department of Health\u2019s Offices of the Chief Medical Examiner and Family Health Services formed a partnership to identify and study pregnancy-associated death in Virginia so that public health prevention and intervention strategies could be developed.\u00a0 Virginia\u2019s Pregnancy-Associated Mortality Surveillance System (PAMSS) uses the broad definition, pregnancy-associated death, for its surveillance focus.\u00a0 Beginning with deaths that occurred in 1999, cases have been identified by the Virginia Department of Health\u2019s Office of Health Statistics using three methods:<\/p>\n

 <\/p>\n