May 25, 2000 (San Francisco) -- In Los Angeles County, where inlaid stars give testament to celebrity on Hollywood Boulevard, women are still dying giving birth to children, says a doctor who studied 17 years of birth records at a Los Angeles hospital.
Robert B. Gherman, MD, says the death rate for women in labor during the years 1982 to 1998 was about 24 per 100,000 live births, a rate that is three times the CDC-reported national average. Gherman says the leading cause of maternal death was a condition called preeclampsia/eclampsia, also known as toxemia.
A very common complication of pregnancy, preeclampsia is characterized by high blood pressure accompanied by painful swelling of feet, legs, and hands. Left untreated, the condition can damage the kidneys and cause seizures. During the 1980s, almost 30% of the maternal deaths at L.A. County Hospital were caused by preeclampsia, says Gherman. The percentage dropped slightly, to about 26%, from 1990 through 1998.
Gherman tells WebMD he collected the data from records of almost 220,000 live births. At the time, Gherman was with the L.A. County/University of Southern California Women's Hospital. "This is an excellent data source because the hospital records are [collected] within 42 days of delivery," says Gherman. Now director of the division of obstetrics/gynecology at the Naval Medical Center Portsmouth in Portsmouth, Va., Gherman presented his research at a meeting of ob/gyns here this week.
Judith Weiss, ScD, director of the Massachusetts Maternal Mortality Study in Boston, tells WebMD that her group will also report maternal death much higher than the CDC rates. The Massachusetts study, she says, defines maternal death as deaths occurring up to a year after delivery. Both the CDC and Gherman use the 42-day cutoff. She says "it is more accurate to extend to a year because many of these delivery-related deaths ... are likely to occur beyond 42 days." She says, however, that "most deaths do occur within the 42 days."
Weiss says her group will be reporting data from 1995 to 1998 "and the rate will be about 25%."
Gherman says the best way to approach the problem of women dying during childbirth is to get high-risk women "out of community hospitals and into large referral centers, where they can be offered state-of-the-art care."
Weiss agrees and says that "there continues to be a need for regional centers that are equipped to handle high-risk cases." She adds that in some cases, such as HIV-infected women, "ob/gyns have to be willing to collaborate with other specialists to deliver care."
The goal of the CDC's Healthy Women 2000 campaign is 3.3 maternal deaths per 100,000 live births, says Gherman. He says, however, "The data from L.A. County suggest that the goal is nowhere in sight."
- A researcher reports that between 1982 and 1998, three times more mothers died in childbirth in a Los Angeles County hospital than the national average reported by the CDC.
- The leading killers were bleeding and preeclampsia (which, in the mother, causes high blood pressure, swelling, and the possibility of kidney damage and seizures).
- Other researchers are also finding their maternal death rates are much higher than the CDC's average. The researchers call for regional centers to be created in order to give mothers at high risk the most advanced care available.