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The California Pregnancy-Associated Mortality Review first convened in 2007. The CA-PAMR committees have varied in size based on the scope of the review and the expertise needed. Currently, there are three committees: a committee conducting rapid-cycle reviews of all pregnancy-related deaths statewide for surveillance, a committee conducting in-depth reviews of deaths from obstetric hemorrhage, and a committee conducting in-depth reviews of all-cause pregnancy-related deaths in a defined region of Southern California. Each committee meets quarterly at minimum. California has between 490,000 and 500,000 live births and approximately 250 pregnancy-associated deaths annually. In the last several years, California had 60 to 70 pregnancy-related deaths annually. Our mission is to conduct ongoing enhanced surveillance, prevent pregnancy-related deaths and eliminate related racial/ethnic disparities.
Contacts
Primary
Name
Paula Krakowiak
Credentials
PhD, MS
Title
CA-PAMR Project Lead
Affiliation
Maternal, Child and Adolescent Health Division, California Department of Public Health
MMRC Role
State Agency Leadership
Epidemiologist/Data Analyst
Secondary
Name
Christine Morton
Credentials
PhD
Title
Research Sociologist
Affiliation
California Maternal Quality Care Collaborative, Stanford University
MMRC Role
Coordinator
Epidemiologist/Data Analyst
Email
Phone
650-995-4550
Secondary
Name
Christy McCain
Credentials
MPH
Title
Research Scientist
Affiliation
Public Health Institute
MMRC Role
Abstractor
Epidemiologist/Data Analyst
Email
Phone
831-566-7420
Sources of Funding
ERASE MM
Yes
STATE MATERNAL HEALTH INNOVATION
No
TITLE V MCH SERVICES BLOCK GRANT
Yes
STATE BUDGET
No
Scope of cases reviewed
All deaths during pregnancy or within one year of the end of pregnancy from a pregnancy complication, a chain of events initiated by pregnancy, or the aggravation of an unrelated condition by the physiologic effects of pregnancy, and not intentional or unintentional injury
A sample of deaths during pregnancy or within one year of the end of pregnancy from a pregnancy complication, a chain of events initiated by pregnancy, or the aggravation of an unrelated condition by the physiologic effects of pregnancy, and not intentional or unintentional injury
A sample of deaths caused by intentional or unintentional injury
Individuals, Disciplines, and Organizations Represented on Review
| Organizations | Core Disciplines | Specialty Disciplines |
|---|---|---|
|
Academic Institutions
Community-Based Doula Program
Professional Assoc. State Chapters
State Medical Society
State Title V Program
|
Anesthesiology
Community Advocates
Community Birth Workers
Family Medicine
Forensic Pathology
Maternal Fetal Medicine/Perinatology
Nurse Midwifery
Obstetrics and Gynecology
Patient Safety
Patient/Family Advocate
Perinatal Nursing
Psychiatry
Public Health
Social Work
|
Cardiology
Community Leadership
Critical Care Medicine
Emergency Response
Epidemiology
Genetics
Mental Health Provider
Public Health Nursing
|
State Materials
California Pregnancy-Associated Mortality Review
2015
The Bulletin updates surveillance data last published through 2010 and provides additional information on maternal mortality through 2013. Data are presented showing declining California trends in comparison to U.S. rates, persistent racial disparities and a slower decline among ‘late’ (43-365 days postpartum) deaths. Potential reasons for the decline are discussed.
California Pregnancy-Associated Mortality Review
2015
A descriptive analysis of pregnancy-related cardiovascular deaths from 2002 to 2006 (n=64). Deaths from cardiomyopathy and other cardiovascular disease were subclassified, and racial and economic disparities, risk factors, timing of deaths and diagnosis, contributing factors, and clinical implications for the prevention of future deaths were identified
California Pregnancy-Associated Mortality Review
2015
A comparison of specific maternal and clinical characteristics and contributing factors among the five leading causes of pregnancy-related mortality: cardiovascular disease, preeclampsia/eclampsia, obstetric hemorrhage, venous thromboembolism and amniotic fluid embolism. Differing patterns for race, maternal age, BMI, timing of death, delivery method and chance to alter the outcome were identified.
California Pregnancy-Associated Mortality Review
2018
This report from the California PAMR presents comprehensive and detailed findings of maternal deaths, with an emphasis on the seven leading causes of pregnancy-related deaths in California from 2002 through 2007.
California Department of Public Health
2016
CA-PAMR Committee members and staff must adhere to policies related to 1) the protection of confidential information and Committee deliberations, 2) the declaration of any potential conflicts of interest, either personally/financially or institutionally, and 3) guidance on when to recuse themselves from case review.
California Pregnancy-Associated Mortality Review
California Health and Safety codes (§§100325, 100330 and 100335) which give California Department of Public Heath the broad authority to investigate sources of morbidity and mortality, such as PAMR.
California Pregnancy-Associated Mortality Review
2011
The first California PAMR report describes the problem of rising maternal mortality rates and makes the case for conduct of maternal mortality reviews. high-level description of methodology, initial findings from review of 2002 – 2003 deaths, and implications for public health, maternity care and women considering a pregnancy are described.
California Pregnancy-Associated Mortality Review
2014
In response to rising maternal mortality rates, California DPH initiated a Pregnancy-Associated Mortality Review. We describe California’s methodology and demonstrate its advantages for improved surveillance, additional case finding, improved accuracy of the causes of pregnancy-related deaths, and translation of evidence to guide development of prevention and quality improvement efforts.