The number of women in Britain dying during pregnancy is rising sharply
The number of women who have died during pregnancy or shortly afterwards has risen sharply to the highest level in two decades, raising concerns among experts.
The maternal mortality rate rose to 13.41 deaths per 100,000 pregnancies between 2020 and 2022, according to figures published by the MBRRACE-UK research into maternal mortality in Great Britain. In the period 2017 to 2019 this was 8.79.
It is the highest death toll since 2003-2005, when the maternal mortality rate was 13.95 deaths per 100,000.
Even excluding maternal deaths from the coronavirus, the maternal mortality rate between 2020 and 2022 (11.54 deaths per 100,000) remains higher than the rate between 2017 and 2019.
Prof. Marian Knight, director of the National Perinatal Epidemiology Unit and head of maternal reporting at MBRRACE-UK, said she was concerned about the figures, adding: “These data show that the UK maternal mortality rate has returned to levels we haven’t seen in recent years. the past twenty years.”
An NHS England spokesperson said: “While the NHS has made significant improvements to maternity care over the past decade, we know that further action is needed to improve the experiences of women and their families across the country.”
A separate study found that women who experience depression during pregnancy or in the first year after the birth of a child are also more than twice as likely to die prematurely, mainly from suicide.
Perinatal depression is one of the most common complications of pregnancy, affecting as many as 20% of women around the time of delivery. Despite the enormous numbers of people affected worldwide, the link between perinatal depression and the risk of death has not been seriously investigated to date.
The link cannot be explained by shared family factors and is independent of pre-existing psychiatric disorders, the study found. The researchers said affected women, their families and health professionals should be aware of these serious health risks.
“Women with clinically diagnosed perinatal depression are at increased risk of mortality, independent of psychiatric history and family factors,” the researchers wrote in the BMJ. “The association is stronger for unnatural deaths, especially due to suicide, and during the first year after diagnosis.”
An international team of researchers investigated whether women with perinatal depression are at increased risk of death compared to unaffected wives and sisters.
Using data from the Swedish National Register from 2001 and 2018, they identified 86,551 women with a first-ever diagnosis of perinatal depression and 865,510 unaffected women, matched by age and calendar year at delivery.
To control for shared family factors, they also compared data from 24,473 women with perinatal depression with 246,113 unaffected full sisters who delivered at least one baby during the study period.
A range of known risk factors for both depression and premature death were taken into account, including socio-economic status, pre-existing psychiatric disorders, adverse birth outcomes and the death of a child within the first year after birth.
The results show that women with perinatal depression were more than twice as likely to die than women who did not have perinatal depression, the BMJ said. The results were similar when comparing deaths between sisters and among women who did and did not have a pre-existing psychiatric disorder.
The increased risk associated with perinatal depression was most pronounced in the first year after diagnosis. It decreased over time but remained higher during the 18 years of follow-up of the study.
Although suicide was rare, women with perinatal depression were six times as likely to die by suicide, and three times as likely to die from an accident, than women who did not have perinatal depression.
These were observational findings and the researchers highlighted several limitations, such as only including women who sought specialist care for their depression and the possible misclassification of some suicide events as accidents.
And although they controlled for a range of factors, including those that occur within families, they could not rule out the possibility that other, unmeasured factors could have influenced their results.
However, they concluded: “Women affected by perinatal depression, their families and health professionals, especially those working in primary, maternal and mental health care, should be aware of the serious health risks regardless of their psychiatric history.
“Early detection and treatment are needed for groups at high risk of perinatal depression to prevent fatal consequences.”