Maternāāal mortality is a key indicator of population health. Deaths in pregnancy and postpartum should be rare events, so routine and accurate surveillance of pregnancy-related deaths is an essential public health responsibility. CA-PMSS is a statewide surveillance of deaths among Californians who were pregnant within the prior year.
The Maternal, Child and Aādolescent Health (MCAH) Division of the California Department of Public Health (CDPH) initiated CA-PMSS in 2018 to provide a timely and accurate accounting of deaths related to or aggravated by the pregnancy or its management. In CA-PMSS, deaths are identified by complex data linkage of vital statistics data and patient-level administrative data from hospitals, emergency departments and ambulatory surgery centers. Coroner and autopsy reports and medical records are used to verify pregnancy status and timing to death. A committee of experts conducts limited case reviews of the deaths to determine the underlying cause of death and whether it was related to pregnancy.
The goal of CA-PMSS is to monitor deaths related to pregnancy using the most accurate information available. While the commonly used maternal mortality ratio (MMR) remains a key indicator of the overall health of a population, it relies solely on death certificate data. CA-PMSS compiles the findings from its more complex data linkage and expert committee review to create a pregnancy-related mortality ratio (PRMR), allowing California to monitor deaths related to pregnancy using the most accurate information available.