Maternal Mortality in the Mississippi Delta Region

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Abstract

Objective

To compare the maternal mortality rate (MMR) in the Mississippi Delta region of the United States with that of the non-Delta region states.

Methods

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.

Results

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).

Conclusions

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.

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