1.6/100,000 live births. The PRMR for patients undergoing
cesarean section delivery was 2.8 compared to 0.2 among
those with vaginal deliveries (95 % CI
=
1.8–4.2 and
0.1–0.5 respectively). Women aged 35 and older had the
highest PRMR at 2.6/100,000 live births. BMI over 30
kg/m
2
and presence of chronic conditions were frequently
identified risk factors. One in five decedents (21.7 %)
reported at least two symptoms suggestive of pulmonary
embolism in the days before death. This combined state-
based maternal death review confirms age over 35 years,
obesity, and the presence of chronic conditions are risk
factors for pregnancy-related mortality due to venous
thromboembolism in the US. Expanding and standardizing
the process of state-based reviews offers the potential for
reducing pregnancy-related mortality in the US.