Premier Data Analysis Update: Maternal and Infant Health Trends, 2008-2020

Key takeaways:

• When it comes to maternal health and outcomes, a large gap still exists between white and Black individuals.
• Severe Maternal Mortality (SMM) continues to disproportionately affect Black individuals, who have a 77 percent higher SMM rate than white individuals.
• Premier’s Perinatal Improvement Collaborative (PPIC) tests interventions and uses data and insights to help inform clinical decisions and spread best practices to help reduce maternal and infant morbidity and mortality.

Premier is focused on raising the bar on quality, safety and cost for maternal and infant care across the U.S. Doing so requires narrowing the gap in outcomes that can be affected by personal characteristics such as gender, race, ethnicity, geographic location and socioeconomic status – all factors that have been shown to play a particular role in maternal and infant health outcomes.

Premier recently conducted a Maternal Health Trends Analysis, which examined data from the Premier Healthcare Database (PHD) and included standardized inpatient data from 10.9 million births that occurred in 921 hospitals across 47 states between 2008-2020. What follows are key findings from that analysis.

The Good News

Overall, the analysis noted that maternal mortality in the hospital, at the time of delivery, is on the decline. Data show a 24 percent decrease in delivery-related maternal deaths between 2008-2020, suggesting progress is being made in the hospital at the time of delivery.

In addition, the disparity gap between Black and white individuals for in-hospital, delivery-related deaths has substantially narrowed over time. Premier data found a 63 percent decrease in delivery-related maternal mortality for Black individuals from 2008-2020.

The Bad News

While this decrease in inpatient deaths is promising, the bad news is that declines in maternal deaths are not evenly distributed across populations. Black mothers and Black babies are two to three times more likely to die as a result of pregnancy or childbirth, according to the Centers for Disease Control and Prevention (CDC).

Equally troubling, the analysis showed a 17 percent increase in severe adverse outcomes postpartum, with Black individuals having a 77 percent higher SMM rate than whites.

Socioeconomic factors also contributed to uneven outcomes, with individuals receiving charity/indigent coverage having adverse event rates 62 percent higher than those with commercial insurance carriers. The Medicaid population was the second group most likely to experience adverse events, with SMM rates that are 31 percent higher than those commercially insured.

Narrowing the Gaps with the Premier Platform

Obtaining a better understanding of the current state of maternal and infant harm is the first step to improving the quality of care. Premier's findings underscore the need for a more integrative approach to the care expectant individuals receive before, during and after delivery to improve outcomes and reduce maternal and infant harm.

The challenges in pinpointing the gaps and working to close them start with data. Currently there isn’t a standardized method of collecting or analyzing maternal and infant data, social determinants or postpartum outcomes in the U.S.

And that’s where the Premier Platform comes in.

To help providers in their journey to better understand the connections between outcomes and the social determinants and personal characteristics that can contribute to them, Premier developed the Maternal Health Database. This standardized and timely data can help clinicians analyze outcomes by tracking maternal and infant data individually, as well as together, linked as a dyad to demonstrate the impact of maternal health on infant outcomes.

In addition, Premier’s Perinatal Improvement Collaborative (PPIC) of more than 200 diverse hospitals and health systems is using the Premier Maternal Health Database to measure outcomes and identify the most effective evidence-based practices and care bundles that can make a positive impact. Together, these systems will collect data and assess the role that health equity and social determinants can have on outcomes, ultimately publishing research that illustrates the maternal and infant relationship and helps illuminate the entire pregnancy journey from prenatal to post-partum.

Working to address these disparities is key to helping improve the nation’s overall health and economic prosperity. One analysis estimates that disparities in care amount to approximately $93 billion in excess medical care costs and $42 billion in lost productivity per year as well as additional economic losses due to premature deaths.

Its clear efforts must continue to improve the well-being of mothers, infants and children. Their well-being determines the health of the next generation and can help predict future public health challenges for families, communities and the healthcare system overall.

Methodology: The Premier national trend analysis explores maternal and infant health outcomes at the time of delivery. It leverages the Premier Healthcare Database and includes standardized inpatient data from 10.9 million births that occurred in 921 hospitals across 47 states from 2008-2020. It builds on Premier’s first maternal and infant health trends analysis that examined 2008-2018 data.

For more:

• Check out Premier Applied Sciences’ Maternal Health Data and learn how it can inform your solution development for maternal and infant health.
• Learn more about Premier’s efforts to improve maternal and infant health.
• Download the full report and check out key trends affecting Black individuals during delivery.

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