The first Maternal Data Registry Demonstration Project conducted in Harris County reports findings and recommendations
Dec. 7, 2022 (HOUSTON) – Leaders of the Maternal Data Registry Demonstration Project, an effort of the Improving Maternal Health (IMH) initiative, released their findings today presenting updated maternal mortality and morbidity data for the Houston region in 2021. Data were derived through the voluntary participation of four hospital systems, that included 23 hospital locations in the region.
The Maternal Data Registry Demonstration is a project funded with support provided by The Cullen Trust for Health Care and Episcopal Health Foundation to help address the various and complex drivers of maternity-related illness and death. A five-member team of obstetricians and maternal-fetal medicine specialists, led by Dr. Sean Blackwell, UTHealth Houston, and Dr. Carey Eppes, Baylor College of Medicine, guided the design and implementation of the registry. Healthcare systems participating in the project included Harris Health System, HCA Healthcare, Memorial Hermann and UTMB Health.
The demonstration project was created to address gaps in administrative data that is currently used to determine the rate of maternal mortality and severe morbidities in the state. By collecting higher quality data from prospective quality review processes or retrospective medical record reviews using pre-selected screening criteria, the registry set out to get a clearer picture of the frequency and cause of several maternal morbidities in Harris County. Additionally, given high interest across the state to understand and address the complex causes of poor maternal outcomes, the unique approach was designed to explore the feasibility of collecting near-real-time hospital data to inform other potential statewide efforts.
Taken together, participating hospitals had 63,851 labor and delivery admissions from January 1 through December 31, 2021. Of these admissions, 736 were identified as severe maternal morbidity (SMM) cases, which equates to a rate of 115.3 patients for every 10,000 deliveries. Among these 736 severe morbidity cases, 16 resulted in death, bringing the maternal mortality (MM) rate to 25.1 for every 100,000 deliveries. Because these rates were established using different screening criteria, they are not directly comparable to other rates.
The findings continue to demonstrate that African American women are more likely to die or experience a severe morbidity event at delivery or in the post-partum period. While African American women made up 17% of all labor and delivery admissions, they accounted for 27% of the severe maternal morbidity cases and 50% of the deaths.
Although the Maternal Data Registry project was not designed to explore drivers of the poor outcomes, the data suggest that women with limited access to care, chronic health conditions prior to pregnancy, and mental health conditions were more likely to experience severe morbidities and mortality in the Houston region.
The project findings reinforce the strategic recommendations made to improve maternal health in the 2018 Community Plan to Improve Maternal Health in Harris County, including: addressing unconscious bias, increasing access to affordable care, increasing access to affordable health insurance, supporting innovative partnerships, expanding best practices in labor and delivery care, and raising awareness of the risks of maternal morbidity among all women.
The IMH steering committee intends for its findings and recommendations to inform and stimulate positive change in Texas that results in more resources and support for maternal health.
Leaders of the registry project caution against comparing their registry data to maternal morbidity data gathered by the State of Texas, or nationally by CDC, given that different data collection methods are used by each entity.
The registry project was co-chaired by Dr. Blackwell and Dr. Eppes. Dr. Carla Ortique, OB-GYN, Texas Children’s Pavilion for Women, is chair of the IMH Steering Committee, a 48-member group made up of community leaders from a wide range of backgrounds, including healthcare, behavioral health, social services, research, business, government and philanthropy, all working together on a community-wide effort to reduce the rate of maternal mortality and morbidity in Harris County. Lead consultant and facilitator for the IMH Initiative and the Maternal Data Registry Demonstration Project is Houston-based Working Partner.
For more information on Improving Maternal Health visit imhhouston.org