MATERNAL MORTALITY TITLE V PERINATAL INDICATORS 2016 INDICATOR: Maternal Mortality Ratio DEFINITION: The number of maternal deaths per 100,000 live births NUMERATOR: The number of maternal deaths defined by death due to pregnancy, childbirth and the puerperium as identified by ICD-9 codes 630-676, or by ICD-10 codes 000-099, by place of residence, in a calendar year DENOMINATOR: The total number of live births, by place of residence, in a calendar year HEALTHY PEOPLE 2020 OBJECTIVE: Reduce maternal deaths to no more than 11.4 per 100,000 live births. (Baseline: 12.7 per 100,000 live births in 2007) (Objective MICH–5) Race/ethnicity; maternal age over thirty; high parity; late entry into prenatal care; lack of comprehensive prenatal care; tobacco use during pregnancy; alcohol/substance abuse during pregnancy RISK FACTORS: California Year Maternal Mortality Los Angeles County 95% Confidence Interval Maternal Mortality Denominator: Live Births 95% Confidence Interval Deaths Ratio Lower Upper Deaths Ratio Lower Upper Year 2007 80 14.1 11.0 17.2 22 14.5 8.4 20.5 2007 566,137 151,813 2008 92 16.7 13.3 20.1 33 22.3 14.7 30.0 2008 551,567 147,684 2009 96 18.2 14.6 21.9 22 15.8 9.2 22.3 2009 526,774 139,679 2010 80 15.7 12.2 19.1 19 14.3 7.9 20.7 2010 509,979 133,160 2011 86 17.1 13.5 20.8 28 21.5 13.5 29.4 2011 502,023 130,313 2012 86 17.1 13.5 20.7 23 17.5 10.3 24.6 2012 503,788 131,697 2013 78 15.8 12.3 19.3 23 17.9 10.6 25.2 2013 494,392 128,523 2014 88 17.5 13.8 21.2 22 16.9 9.8 24.0 2014 502,973 130,150 2015 84 17.1 13.4 20.7 17 13.7 7.2 20.1 2015 491,748 124,507 2016 91 18.6 14.8 22.4 22 17.9 10.4 25.4 2016 488,827 122,941 Sources: California Department of Public Health, Birth and Death Statistical Master Files, 2007-2016 Centers for Disease Control and Prevention, National Center for Health Statistics. Underlying Cause of Death on CDC WONDER Online Database, released December, 2018, 2014-2016 Page 1 California LA County Maternal Deaths per 100,000 Live Births California vs. Los Angeles County, 2007-2016 California Los Angeles County Healthy People 2020 25.0 Deaths per 100,000 live births 20.0 15.0 10.0 5.0 0.0 2007 2008 2009 2010 2011 2012 2013 2014 2015 Year Sources: California Department of Public Health, Birth and Death Statistical Master Files, 2007-2016 Centers for Disease Control and Prevention, National Center for Health Statistics. Underlying Cause of Death on CDC WONDER Online Database, released December, 2018, 2014-2016 Page 2 2016 Maternal Mortality Ratio (per 100,000 live births) by Race/Ethnicity, Los  Angeles County, 10‐Year Average, 2004‐2016 70.0 61.3 63.5 65.1 65.8 60.0 50.0 40.0 30.0 20.0 16.1 15.5 14.4 13.9 12.8 14.3 12.8 13.2 13.4 13.2 13.8 12.4 10.0 0.0 WHITE HISPANIC 2004 to 2013 2004 to 2013 2005 to 2014 2006 to 2015 2007 to 2016 Deaths 39 37 34 29 WHITE Live Births 242,414 238,803 235,872 233,025 MMR 16.1 15.5 14.4 12.4 Deaths 115 113 108 109 AFRICAN AMERICAN 2005 to 2014 HISPANIC Live Births 869,044 845,716 820,660 791,836 2006 to 2015 MMR Deaths 13.2 64 13.4 65 13.2 65 13.8 64 ASIAN 2007 to 2016 AFRICAN AMERICAN Live Births 104,378 102,406 99,907 97,263 MMR Deaths 61.3 23 63.5 22 65.1 25 65.8 23 ASIAN Live Births 164,883 171,516 175,169 179,017 MMR 13.9 12.8 14.3 12.8 HP 2020 Objective Reduce maternal deaths to no more than 11.4 per 100,000 live births.  Note:  Maternal Mortality Ratio is defined as the number of maternal deaths defined by death due to pregnancy, childbirth and the puerperium as  identified by ICD‐10 codes O00‐O99 per 100,000 live births. Source: California Department of Public Health, 2004‐2016 Birth and Death Statistical Files Page 3 Maternal Mortality Ratio (per 100,000 live births) by Service Planning Area Los Angeles County, 10‐Year Average, 2004‐2016 2004 to 2013 35.0 2005 to 2014 2006 to 2015 32.3 2007 to 2016 31.6 29.4 30.0 28.2 26.1 25.0 21.4 22.9 22.9 20.0 15.0 10.0 5.0 0.0 SPA 1 SPA 1 SPA 2 SPA 3 SPA 4 SPA 5 SPA 6 SPA 7 SPA 8 Countywide SPA 2 SPA 3 SPA 4 SPA 5 SPA 6 SPA 7 SPA 8 Countywide 2004 to 2013 2005 to 2014 2006 to 2015 2007 to 2016 Live Live Live Live MMR Deaths Births MMR Deaths Births MMR Deaths Births MMR Deaths Births 9 57,844 15.6 10 58,107 17.2 10 58,071 17.2 10 57,486 17.4 34 272,579 12.5 32 268,572 11.9 29 263,990 11.0 29 258,786 11.2 33 245,274 13.5 31 246,691 12.6 32 244,838 13.1 26 243,184 10.7 16 152,910 10.5 15 148,469 10.1 19 144,467 13.2 23 139,497 16.5 7 68,863 10.2 7 68,867 10.2 8 68,728 11.6 8 68,551 11.7 67 207,356 32.3 64 202,442 31.6 58 197,230 29.4 54 191,470 28.2 32 197,953 16.2 34 192,325 17.7 34 187,067 18.2 30 181,709 16.5 45 209,972 21.4 47 205,567 22.9 46 200,655 22.9 51 195,284 26.1 246 1,416,590 17.4 242 1,395,236 17.3 237 1,369,301 17.3 231 1,340,405 17.2 HP 2020 Objective Reduce maternal deaths to no more than 11.4 per 100,000 live births.  Note:  Maternal Mortality Ratio is defined as the number of maternal deaths defined by death due to pregnancy, childbirth and the puerperium as  identified by ICD‐10 codes O00‐O99 per 100,000 live births. Sum of SPAs may not equal to the Countywide total as deaths which could not be allocated to a SPA are excluded from the analyses. Source: California Department of Public Health, 2004‐2016 Birth and Death Statistical Files Page 4