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Canada's pregnancy-related mortality rates: doing well but room for improvement

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Abstract
Purpose: Canada's perinatal, infant and maternal mortality rates were examined and compared with other Organization for Economic Cooperation and Development (OECD) countries. The type and the quality of the available data and best practices in several OECD countries were evaluated. Source: A literature search was performed in PubMed and the Cochrane Library. Vital statistics data were obtained from the OECD Health Database and Statistics Canada and subjected to secondary analysis. Principal findings: Overall, Canadian pregnancy mortality rates have fallen dramatically since the early 1960's. Perinatal and infant mortality rates remain low and stable, but the maternal mortality rate has increased slightly and both mortality rates have declined in their relative OECD rankings over the last 20 years. Data quality and coverage across Canada and internationally, especially for Indigenous peoples, is inconsistent and registration practices differ greatly, making comparisons difficult. Available data do show that Indigenous people's perinatal and infant mortality rates are nearly twice those of the general population. Best practices in other OECD countries include Australia's National Maternity Services plan to improve Aboriginal perinatal health, the Netherlands' midwifery services and National Perinatal Registry and Japan's national pregnancy registration and Maternal Handbook. Conclusion: To diminish Canadian disparities in perinatal health rates and improve health outcomes we recommend a) uniform registration practices across Canada, b) better data quality and coverage especially among Indigenous communities, c) adoption of a national pregnancy registration and a maternal handbook along with d) improved midwifery and primary practice services to rural and remote communities. At a time when Canada is focusing upon improving pregnancy health in developing nations, it also needs to address its own challenges in improving pregnancy outcomes.
Keywords
DELAYED CHILDBEARING, CONGENITAL HEART-DISEASE, INTERNATIONAL COMPARISONS, MATERNAL MEDICAL DISEASE, PLANNED HOSPITAL BIRTHS, PRETERM BIRTH, UNITED-STATES, RISK-FACTORS, 1ST NATIONS, NONABORIGINAL INFANTS BORN

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Citation

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MLA
Verstraeten, Barbara, et al. “Canada’s Pregnancy-Related Mortality Rates: Doing Well but Room for Improvement.” CLINICAL AND INVESTIGATIVE MEDICINE, vol. 38, no. 1, 2015, pp. E15–36.
APA
Verstraeten, B., Mijovic-Kondejewski, J., Takeda, J., Tanaka, S., & Olson, D. M. (2015). Canada’s pregnancy-related mortality rates: doing well but room for improvement. CLINICAL AND INVESTIGATIVE MEDICINE, 38(1), E15–E36.
Chicago author-date
Verstraeten, Barbara, Jane Mijovic-Kondejewski, Jun Takeda, Satomi Tanaka, and David M Olson. 2015. “Canada’s Pregnancy-Related Mortality Rates: Doing Well but Room for Improvement.” CLINICAL AND INVESTIGATIVE MEDICINE 38 (1): E15–36.
Chicago author-date (all authors)
Verstraeten, Barbara, Jane Mijovic-Kondejewski, Jun Takeda, Satomi Tanaka, and David M Olson. 2015. “Canada’s Pregnancy-Related Mortality Rates: Doing Well but Room for Improvement.” CLINICAL AND INVESTIGATIVE MEDICINE 38 (1): E15–E36.
Vancouver
1.
Verstraeten B, Mijovic-Kondejewski J, Takeda J, Tanaka S, Olson DM. Canada’s pregnancy-related mortality rates: doing well but room for improvement. CLINICAL AND INVESTIGATIVE MEDICINE. 2015;38(1):E15–36.
IEEE
[1]
B. Verstraeten, J. Mijovic-Kondejewski, J. Takeda, S. Tanaka, and D. M. Olson, “Canada’s pregnancy-related mortality rates: doing well but room for improvement,” CLINICAL AND INVESTIGATIVE MEDICINE, vol. 38, no. 1, pp. E15–E36, 2015.
@article{7069048,
  abstract     = {{Purpose: Canada's perinatal, infant and maternal mortality rates were examined and compared with other Organization for Economic Cooperation and Development (OECD) countries. The type and the quality of the available data and best practices in several OECD countries were evaluated. 
Source: A literature search was performed in PubMed and the Cochrane Library. Vital statistics data were obtained from the OECD Health Database and Statistics Canada and subjected to secondary analysis. 
Principal findings: Overall, Canadian pregnancy mortality rates have fallen dramatically since the early 1960's. Perinatal and infant mortality rates remain low and stable, but the maternal mortality rate has increased slightly and both mortality rates have declined in their relative OECD rankings over the last 20 years. Data quality and coverage across Canada and internationally, especially for Indigenous peoples, is inconsistent and registration practices differ greatly, making comparisons difficult. Available data do show that Indigenous people's perinatal and infant mortality rates are nearly twice those of the general population. Best practices in other OECD countries include Australia's National Maternity Services plan to improve Aboriginal perinatal health, the Netherlands' midwifery services and National Perinatal Registry and Japan's national pregnancy registration and Maternal Handbook. 
Conclusion: To diminish Canadian disparities in perinatal health rates and improve health outcomes we recommend a) uniform registration practices across Canada, b) better data quality and coverage especially among Indigenous communities, c) adoption of a national pregnancy registration and a maternal handbook along with d) improved midwifery and primary practice services to rural and remote communities. At a time when Canada is focusing upon improving pregnancy health in developing nations, it also needs to address its own challenges in improving pregnancy outcomes.}},
  author       = {{Verstraeten, Barbara and Mijovic-Kondejewski, Jane and Takeda, Jun and Tanaka, Satomi and Olson, David M}},
  issn         = {{0147-958X}},
  journal      = {{CLINICAL AND INVESTIGATIVE MEDICINE}},
  keywords     = {{DELAYED CHILDBEARING,CONGENITAL HEART-DISEASE,INTERNATIONAL COMPARISONS,MATERNAL MEDICAL DISEASE,PLANNED HOSPITAL BIRTHS,PRETERM BIRTH,UNITED-STATES,RISK-FACTORS,1ST NATIONS,NONABORIGINAL INFANTS BORN}},
  language     = {{eng}},
  number       = {{1}},
  pages        = {{E15--E36}},
  title        = {{Canada's pregnancy-related mortality rates: doing well but room for improvement}},
  volume       = {{38}},
  year         = {{2015}},
}

Web of Science
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