Indiana Maternal Mortality Review Committee 2022 Annual Report

Executive Summary

Maternal mortality can be an indicator of the overall health of a community or state. Maternal
Mortality Review committees identify and examine pregnancy-associated deaths to understand
their causes and contributing factors and ultimately put forth recommendations for preventing
them in the future.

Indiana began developing its MMRC in 2017. Legislation mandating its formalization took effect
in July 2018, and the State Health Commissioner appointed members who began reviewing all
pregnancy-associated deaths in the fall of 2018. The current multidisciplinary committee has
completed the review of all pregnancy-associated deaths that occurred in 2020. The goal of the
work is to better understand the causes and preventability of these incidents.

Identification of all deaths of Indiana women during and within one year of pregnancy resulted
in maternal mortality statistics that differ greatly from those traditionally reported by the
National Vital Statistics System (NVSS) and the Pregnancy Mortality Surveillance System (PMSS),
respectively. NVSS relies exclusively on death certificate coding and includes only women up to
42 days post-partum. PMSS data includes women through one year from the end of pregnancy
and establishes pregnancy-relatedness through review by CDC epidemiologists. A significant
number of false positives were identified in the NVSS dataset and were ultimately excluded by
the Indiana MMRC, and an equally significant number of cases were identified by the Indiana
MMRC through matching, facility reporting, and other means that were not identified in the
NVSS dataset (false negatives). The MMRC-derived data presented in this report reflect the
burden of maternal mortality in Indiana more accurately and cannot be compared to other
datasets.

Source: Indiana Department of Health (2022). Indiana Maternal Mortality Review Committee, 2022 Annual Report.