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The Florida Department of Health works to protect, promote & improve the health of all people in Florida through integrated state, county, & community efforts.

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PAMR

Contact the Infant, Maternal, and Reproductive Health Program

  • 850-245-4465
  • Mailing Address

    4052 Bald Cypress Way, Bin A13

    Tallahassee, FL 32399-1721

Pregnancy-Associated Mortality Review (PAMR)

History

In 1996, the Florida Department of Health initiated the Pregnancy-Associated Mortality Review (PAMR) to improve surveillance and analysis of pregnancy-related deaths in Florida.  This case review program seeks to elucidate gaps in care, identify systemic service delivery issues, and make recommendations to facilitate improvements in the overall systems of care.

Process

The process begins by identifying all pregnancy -associated deaths within a specified period.  A pregnancy -associated death is defined as "a death to a woman from any cause, while she is pregnant or within 1 year of termination of the pregnancy, regardless of duration and site of the pregnancy."  A pregnancy-associated death is identified utilizing linked data files from four sources associated with the mother:

Death certificates identified by the assigned cause of death being in the category of Pregnancy, Childbirth and the Puerperium (pregnancy related)

  • Healthy Start screen
  • Birth Certificate
  • Fetal death certificate

Once the pregnancy-associated deaths are identified, they are sorted by a physician/nurse subcommittee and initially deemed pregnancy-related, possibly pregnancy-related or not pregnancy-related.  The focus of PAMR is to assure that all deaths identified as pregnancy-related deaths are reviewed.

Definitions

A pregnancy-related death is defined as “a pregnancy-associated death resulting from 1) complications of the pregnancy itself, 2) the chain of events initiated by the pregnancy that led to death or 3) aggravation of an unrelated condition by the physiologic or pharmacologic effects of the pregnancy that subsequently caused the death. "

It is important to note that Maternal Mortality Rates (MMR) reported by the Office of Vital Statistics are based on deaths identified by the assigned cause of death being in a pregnancy related category and in recent years by the addition of a pregnancy check box on the death certificate.  Vital Statistics defines maternal mortality as "the death to a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy, from any cause related to or aggravated by pregnancy or its management but not from accidental or incidental causes.”

Through the utilization of a broader definition, as well as the increased sources of linked data, The Pregnancy-Associated Mortality Review is able to assess more accurately the pregnancy-related deaths in Florida.