Data collection changes key to understanding maternal mortality trends in the US, new study shows

University of Oxford

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A new study led by researchers at the University of Oxford, published today (28 April) in JAMA Pediatrics, offers fresh insight into trends in maternal mortality in the United States. For the first time, the study disentangles genuine changes in health outcomes from shifts caused by how deaths are recorded. Nevertheless, the study confirms the devastating impact of the COVID-19 pandemic on maternal death rates for women of all racial and ethnic groups.

The study, based on data from 2000 to 2023, investigated how the introduction of a ‘pregnancy checkbox’ on death certificates—implemented at different times across US states—affected reported maternal death rates. The team, which included researchers from Brown University and Columbia University, compared states where the checkbox had been implemented with those who had yet to introduce the policy – an approach known as ‘difference-in-differences analysis.’

According to the results, introducing the checkbox accounted for two thirds (66%) of the rise in maternal deaths between 2000-2019, adding an additional 6.8 deaths per 100,000 live births each year. Once adjusted, maternal mortality rates remained largely stable for much of the pre-pandemic period.

However, a sharp increase was recorded in 2021 during the COVID-19 pandemic, with adjusted maternal mortality rates peaking at 18.9 deaths per 100,000 live births—nearly double the rate of previous years (between 6.8 and 10.2 deaths per 100,000 live births). This sharp increase was seen for women of all age groups (except 15-19 years), and across all racial and ethnic groups. Rates returned to pre-pandemic levels by 2022.

Senior author Associate Professor Seth Flaxman (Department of Computer Science, University of Oxford) said: “We started this study by asking what we assumed was a simple question: has the number of pregnant women who die each year in the United States gone up or down since the year 2000? As is so often the case in public health, the numbers do not speak for themselves. At the height of the COVID-19 pandemic, pregnant women died at significantly higher rates than they did before the pandemic. But when we took a careful look at the two decades before the pandemic, we found remarkably little change: in 2019 and 2023, pregnant women died at roughly the same rates as they did a generation earlier.”

The study also highlighted persistent and striking disparities among different demographic groups. Maternal mortality among non-Hispanic Black women was consistently around three to four times higher than that of non-Hispanic White women throughout the study period. For instance, before the COVID-19 pandemic, maternal mortality for non-Hispanic Black women was 20.7 per 100,000 live births compared with 5.0 for non-Hispanic White women.

Whilst all demographic groups were impacted by the COVID-19 pandemic, Native American or Alaska Native women saw the largest increase during the pandemic period, with mortality rates nearly tripling from 10.7 to 27.5 deaths per 100,000 live births.

By contrast, fetal and infant mortality rates showed a general decline from 2000 through 2020. Infant mortality dropped from 6.9 to 5.4 deaths per 1,000 live births during this period, though a small increase was observed from 2021 onward.

Lead author Robin Y. Park (PhD student in Engineering Science, University of Oxford) said: “By accounting for changes in reporting, our study clarifies the significant impact of public health emergencies on maternal outcomes. Any future initiatives on pandemic preparedness should consider provisions for childbirth and postpartum care to limit preventable maternal deaths.”

Co-author Assistant Professor Robbie M. Parks (Columbia University) said: “The public should be informed about how important accurately tracking death rates are for public health action. Our analysis here is an example of how important it is to take into account changes in data collection, which could lead in some cases to opposite conclusions”.

Co-author Assistant Professor Alyssa Bilinski (Brown University) added: “Amidst declining funding for public health surveillance in the US, our results underscore the importance of investing in systems that systematically collect and rigorously analyse maternal and infant health data to inform policy. They also suggest additional questions, particularly how best to reduce significant racial disparities in poor outcomes and how to best understand the comparability of US metrics to peer countries.”

The data for the study was provided via the National Vital Statistics Service (NVSS), a repository of publicly available data managed by the Centres of Disease Control (CDC).

Notes to editors:

For media requests and interviews contact Seth Flaxman: seth.flaxman@cs.ox.ac.uk

The study ‘Trends in Maternal, Fetal and Infant Mortality in the US, 2000-2023’ will be published in JAMA Pediatrics at 16:00 BST / 11:00 ET Monday 28 April at doi:10.1001/jamapediatrics.2025.0440. Advance views of the paper are available via the JAMA tipsheet on EurekAlert.

About the University of Oxford

Oxford University has been placed number 1 in the Times Higher Education World University Rankings for the ninth year running, and ​number 3 in the QS World Rankings 2024. At the heart of this success are the twin-pillars of our ground-breaking research and innovation and our distinctive educational offer.

Oxford is world-famous for research and teaching excellence and home to some of the most talented people from across the globe. Our work helps the lives of millions, solving real-world problems through a huge network of partnerships and collaborations. The breadth and interdisciplinary nature of our research alongside our personalised approach to teaching sparks imaginative and inventive insights and solutions.

Through its research commercialisation arm, Oxford University Innovation, Oxford is the highest university patent filer in the UK and is ranked first in the UK for university spinouts, having created more than 300 new companies since 1988. Over a third of these companies have been created in the past five years. The university is a catalyst for prosperity in Oxfordshire and the United Kingdom, contributing £15.7 billion to the UK economy in 2018/19, and supports more than 28,000 full time jobs.

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Journal

JAMA Pediatrics

DOI

10.1001/jamapediatrics.2025.0440 

Article Title

Trends in Maternal, Fetal and Infant Mortality in the US, 2000-2023

Article Publication Date

28-Apr-2025

Trends in maternal, fetal, and infant mortality in the US, 2000-2023

JAMA Pediatrics

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About The Study: The results of this study suggest that maternal health was difficult to track due to changes in reporting practices, but public health emergencies such as the COVID-19 pandemic can have large negative impacts.

Corresponding Author: To contact the corresponding author, Seth Flaxman, PhD, email seth.flaxman@cs.ox.ac.uk.

To access the embargoed study: Visit our For The Media website at this link https://media.jamanetwork.com/

(doi:10.1001/jamapediatrics.2025.0440)

Editor’s Note: Please see the article for additional information, including other authors, author contributions and affiliations, conflict of interest and financial disclosures, and funding and support.

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https://jamanetwork.com/journals/jamapediatrics/fullarticle/10.1001/jamapediatrics.2025.0440?guestAccessKey=6373041a-2cbe-4236-9947-287ec4b8491a&utm_source=for_the_media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=042825

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Journal

JAMA Pediatrics

All-cause mortality and life expectancy by birth cohort across US states

JAMA Network Open

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About The Study: Cohort-specific patterns across states reveal wide disparities in mortality. Some states have experienced little or no improvements in life expectancy from the 1900 to 2000 birth cohorts. Understanding how mortality patterns vary by birth cohort within each state can inform decision-making around resource allocation and public health interventions.

Corresponding Author: To contact the corresponding author, Theodore R. Holford, PhD, email theodore.holford@yale.edu.

To access the embargoed study: Visit our For The Media website at this link https://media.jamanetwork.com/

(doi:10.1001/jamanetworkopen.2025.7695)

Editor’s Note: Please see the article for additional information, including other authors, author contributions and affiliations, conflict of interest and financial disclosures, and funding and support.

#  #  #

 https://jamanetwork.com/journals/jamanetworkopen/fullarticle/10.1001/jamanetworkopen.2025.7695?guestAccessKey=c0957767-f5eb-4d6d-88a4-15c747418b57&utm_source=for_the_media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=042825

About JAMA Network Open: JAMA Network Open is an online-only open access general medical journal from the JAMA Network. On weekdays, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication. 

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Journal

JAMA Network Open

 

$1M gift to keep Soybean Innovation Lab operational after USAID closure

University of Illinois College of Agricultural, Consumer and Environmental Sciences

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Peter Goldsmith (left) and Dennis Banda in Malawi at a site participating in the Soybean Innovation Lab’s Pan African Soybean Trials. SIL was abruptly left with no funding after USAID shut down; now, a private donation will keep the project afloat for a year with the hope for more durable federal funding. 

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Credit: University of Illinois Urbana-Champaign

URBANA, Ill. -- In February, the USAID-funded Feed the Future Soybean Innovation Lab at the University of Illinois Urbana-Champaign was told to stop work, bringing an abrupt end to 12 years of progress toward developing a global soybean value chain supporting Sub-Saharan Africa, Asia, Latin America, and Australia. SIL director Pete Goldsmith cobbled together funding from the university to keep the lab afloat until April 15, which was to be its last day. 

At the eleventh hour, Founders Pledge, a global nonprofit empowering entrepreneurs to do the most good possible with their charitable giving, announced a $1.02 million gift from an anonymous donor to fund the lab and core staff for another year. While durable federal investments are necessary to support the previous scale of SIL’s work and that of the university as a whole, the reprieve will allow SIL to complete some of its most critical work and give Goldsmith time to seek stable funding into the future. 

“We will use the gift to restart our efforts with our partners and clients bringing soybean to the Lower Shire Valley of southern Malawi — diversifying the Lower Shire economy and leveraging recent World Bank irrigation investments,” said Goldsmith, emeritus professor in the Department of Agricultural and Consumer Economics in the College of Agricultural, Consumer and Environmental Sciences at Illinois. 

SIL and local partners had only just begun developing the soybean industry in southern Malawi, where a hotter, low-elevation environment presents unique challenges. 

Bruce Carruthers, who consults for Agricane in southern Malawi, said, “SIL’s efforts were strategically positioned to expedite the registration of new varieties for both rainy-season and dry-season production, an advancement that would mark a significant milestone in Malawian agriculture. The cessation of SIL’s involvement would have resulted in a slowdown of variety development and release, ultimately delaying the introduction of improved genetic material into the agricultural sector.” 

Goldsmith points out that although SIL’s work has direct benefits for African farmers and agribusinesses, building the African soybean value chain also represents a major boon for the U.S. and global economies.

“Africa is the last frontier for soybean. It’s one of the fastest-growing areas and has huge potential. But someone has to go in and de-risk commercial interests. That's what SIL does,” Goldsmith said. “We go in and de-risk, build the market, and reduce uncertainty so that farmers in trade can follow on. And it's not just farmers, it's traders, it's processors. We've been very effective at it. Without us, there's no plan B.”

Continued funding keeps African and world soybean markets moving in the right direction. Give now to support SIL’s work; visit the donation page, select “other” as your gift designation, and enter “336899 — Soybean Innovation Lab (SIL).” 

 

Personality traits shape our prosocial behavior

University of Zurich

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People’s willingness to do volunteer work or give to charity differs greatly. Besides financial and social incentives, individual differences in people’s personality can explain why some of us are more likely to contribute to community welfare than others.

Researchers at the Department of Psychology of the University of Zurich have examined the links between the so-called Big Five personality traits (openness, conscientiousness, extraversion, agreeableness, neuroticism) and people’s willingness to engage in prosocial behavior. Their analysis was based on 29 international studies comprising more than 90,000 participants. It included different methods to describe people’s personality and covered various forms of philanthropic engagement.

Personality traits matter

The study findings show that two personality traits in particular are linked to philanthropic engagement. Sociability and assertiveness (extraversion) positively correlate with volunteering. In other words, extraverts are more likely to do volunteer work. Meanwhile, agreeableness correlates more closely with a willingness to give money to charity. This behavior may be explained by the fact that agreeable people tend to be more compassionate and considerate of other people’s feelings.

Research on the other personality traits, however, yielded mixed results. For example, there was no clear link between conscientiousness and philanthropic engagement. Openness and neuroticism also appeared to have little effect on people’s prosocial behavior.

New strategies to promote volunteering and donating

“Our findings confirm that individual differences in personality play a role in whether and how much people engage in prosocial behavior,” says Wiebke Bleidorn, first author and professor of psychology at the University of Zurich. She believes that a better understanding of these links can help to encourage people to contribute to the common welfare based on their individual strengths and motivations.

The study thus not only provides valuable scientific insights but also practical guidance for organizations and policymakers wishing to promote volunteering and charitable giving. “This knowledge can be used to develop more targeted strategies aimed at promoting volunteering and charitable giving,” says Christopher J. Hopwood, last author and professor of psychology.

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Journal

Journal of Personality and Social Psychology

DOI

10.31234/osf.io/4sjhg_v1 

Method of Research

Observational study

Subject of Research

People

Article Title

Personality Traits and Traditional Philanthropy: A Systematic Review and Meta-Analysis.

 

UCLA breakthrough extends fuel cell lifespan beyond 200,000 hours, paving the way for clean long-haul trucking

A novel design using pure platinum, graphene-protective layer and porous carbon support could enable fuel cells to power heavy-duty trucks reliably

University of California - Los Angeles

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Schematic illustration of the graphene-protected nanocatalyst structure with a scanning transmission microscope showing the platinum nanoparticle embedded in a pocket of graphene.

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Credit: Huang Research Group/UCLA

For trucks and heavy-duty vehicles that must travel long distances without frequent, time-consuming charging stops, batteries often fall short. Hydrogen fuel cells — which can be refueled as quickly as traditional gasoline — offer a cleaner, more efficient alternative.

Now, researchers at UCLA have made a breakthrough that could dramatically extend the lifespan of these fuel cells, making them a more viable clean energy source that can help bring sustainable, long-haul trucking closer to reality.

Led by Yu Huang, a professor of materials science and engineering at the UCLA Samueli School of Engineering, the research team has developed a new catalyst design capable of pushing the projected fuel cell catalyst lifespans to 200,000 hours, which is nearly seven times the U.S. Department of Energy’s target for 2050. Published in Nature Nanotechnology, the research marks a significant step toward the widespread adoption of fuel cell technology in heavy-duty vehicles, such as long-haul tractor trailers.

Although medium- and heavy-duty trucks make up only about 5% of vehicles on the road, they are responsible for nearly a quarter of greenhouse gas automobile emissions, according to federal estimates. This makes heavy-duty applications an ideal entry point for polymer electrolyte membrane fuel cell technology.

Because fuel cells are significantly lighter than batteries, they require less energy to move the vehicles. With a projected power output of 1.08 watts per square centimeter, fuel cells featuring the new catalyst can deliver the same performance as conventional batteries that weigh up to eight times more. This difference is especially relevant for heavy-duty vehicles, which not only carry substantial cargo but also tend to be much heavier than standard vehicles. In addition, building a national hydrogen-refueling infrastructure would likely require less investment than establishing an electric vehicle-charging network across the country.

Fuel cells work by converting the chemical energy stored in hydrogen into electricity, emitting only water vapor as a byproduct. This has made them a promising solution for cleaner transportation. However, the slow chemical reaction for the energy conversion has been a challenge, requiring a catalyst to achieve practical speeds.

While platinum-alloy catalysts have historically delivered superior chemical reaction, the alloying elements leach out over time, diminishing catalytic performance. The degradation is further accelerated by the demanding voltage cycles required to power heavy-duty vehicles.

To address this challenge, the UCLA team has engineered a durable catalyst architecture with a novel design that shields platinum from the degradation typically observed in alloy systems.

The researchers began by embedding ultrafine platinum nanoparticles within protective graphene pockets. Composed of a single layer of carbon atoms arranged in a two-dimensional honeycomb lattice, graphene is the thinnest known material. Despite its atomic thinness, it is incredibly strong, lightweight and highly conductive. These graphene-encased nanoparticles were then nested inside the porous structure of Ketjenblack, a powdery carbon material. This “particles-within-particles” design provides long-term stability while preserving the high catalytic activity essential for efficient fuel cell performance.

“Heavy-duty fuel cell systems must withstand harsh operating conditions over long periods, making durability a key challenge,” said Huang, who holds the Traugott and Dorothea Frederking Endowed Chair at UCLA Samueli. “Our pure platinum catalyst, enhanced with a graphene-based protection strategy, overcomes the shortcomings of conventional platinum alloys by preventing the leaching of alloying elements. This innovation ensures that the catalyst remains active and robust, even under the demanding conditions typical of long-haul applications.”

The new catalyst exhibited a power loss of less than 1.1% after an accelerated stress test involving 90,000 square-wave voltage cycles designed to simulate years of real-world driving, where even a 10% loss is typically considered excellent. These superior results project fuel cell lifetimes exceeding 200,000 hours, far surpassing the DOE’s target of 30,000 hours for heavy-duty proton exchange membrane fuel cell systems.

By successfully addressing the dual challenges of catalytic activity and durability, UCLA researchers’ innovative catalyst design holds great promise for the adoption of hydrogen-powered heavy-duty vehicles — an essential step toward reducing emissions and improving fuel efficiency in a sector that accounts for a substantial share of transportation energy use.

The team’s findings built on its earlier success in developing a fuel cell catalyst for light-duty vehicles that demonstrated a lifespan of 15,000 hours — nearly doubling the DOE’s target of 8,000 hours.

The new study’s lead authors are UCLA Ph.D. graduates Zeyan Liu and Bosi Peng, both advised by Huang, whose research group specializes in developing nanoscale building blocks for complex materials, such as fuel cell catalysts. Xiaofeng Duan, a professor of chemistry and biochemistry at UCLA, and Xiaoqing Pan, a professor of materials science and engineering at UC Irvine, are also authors on the paper. Huang and Duan are both members of the California NanoSystems Institute at UCLA.

Other authors on the paper are Yu-Han “Joseph” Tsai and Ao Zhang from UCLA, as well as Mingjie Xu, Wenjie Zang, XingXu Yan and Li Xing from UC Irvine. 

UCLA’s Technology Development Group has filed a patent on the technology.

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Journal

Nature Nanotechnology

DOI

10.1038/s41565-025-01895-3 

Method of Research

Experimental study

Subject of Research

Not applicable

Article Title

Pt catalyst protected by graphene nanopockets enables lifetimes of over 200,000 h for heavy-duty fuel cell applications

Article Publication Date

24-Mar-2025

COI Statement

Authors Yu Huang, Xiaofeng Duan, Bosi Peng and Zeyan Liu are inventors on patents relating to this study filed by the University of California, Los Angeles (US patent application 63/222,293).

 

Updated equestrian helmet ratings system adds racing and high-speed events

Building on previous research, the Virginia Tech Helmet Lab released an updated set of equestrian ratings that considers impact scenarios where the horse and rider are moving with horizontal velocity, which typically occurs in racing and cross-country eve

Virginia Tech

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The Virginia Tech Helmet Lab's updated equestrian ratings incorporate head impacts during falls at high speed.

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Credit: Photo by Lee Friesland for Virginia Tech.

Falling off a horse at high-speed changes the impact to the rider’s head and the parameters for a quality helmet, according to new research from the Virginia Tech Helmet Lab.  

Published on April 28 in the Annals of Biomedical Engineering, the findings from researchers Steve Rowson and Lauren Duma indicate that head impacts during falls at high speed generate unique head rotation, which in turn, directly affects helmet behavior. 

“Rotational motion of the head is very important,” said Rowson, helmet lab director. “While our testing already incorporated rotational head motion, falling off a horse at high speed can put a large force across the helmet and generate rotation in a different way than our previous testing. This means that the helmets behave a little differently during low-speed and high-speed impact scenarios.” 

Lauren Duma, a Ph.D. student and member of the lab, was the lead author of the study. 

The new study builds on the lab’s previous work that documented video-captured falls in a wide array of equestrian disciplines, where riders fell from varying heights on the front, side, and back of the helmet. Horse racing and other high-speed accidents were not included with the initial research project. 

The testing now includes impact scenarios where the horse and rider are moving with horizontal velocity, which typically occurs in racing and cross-country events.  

The additional testing criteria were motivated by the Federation Equestre Internationale's (FEI) technical report on new testing protocols for improved equestrian helmet performance, which included horse racing accidents. The added tests were used to update the lab’s original helmet ratings, which were released in December 2022.  

“FEI suggested a new testing standard where the head is dropped on an angled surface, which is very similar to how we already test bicycle helmets in the lab,” Rowson said. “This test does a great job of simulating high-speed falls, so we worked to include tests similar to the FEI specification to have a more comprehensive test protocol.” 

In addition to various fall scenarios, the lab also performed a large computational modeling analysis of the head impacts to identify the best method for quantifying injury risk to the rider. 

Previously, the lab’s STAR ratings only incorporated one method of testing – either the pendulum impactor used for football helmets or the oblique drop tower used for bike and snow sport helmets. This was the first time ratings have been generated using both tests and with 49 helmets tested, the lab’s largest study on equestrian helmets to date. 

Ratings reflect the concussion risk associated with each model and are meant to inform consumer decisions about helmet purchasing. Helmets are rated on a scale of one to five stars, with a one-star helmet offering the least head protection, making it more likely for an individual to develop a concussion, and a five-star helmet offering the most protection and reducing concussion risk. 

Updated ratings are available on the helmet lab website. Early research was funded by Jacqueline Mars, the United States Hunter Jumper Association, the United States Equestrian Federation, the United States Eventing Association, and an anonymous private donor.

Original Study DOI: 10.1007/s10439-025-03723-0

Lauren Duma, a Ph.D. student in neuroscience, prepares an equestrian helmet for oblique testing on the lab's drop tower.

Credit

Photo by Lee Friesland for Virginia Tech.

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Journal

Annals of Biomedical Engineering

DOI

10.1007/s10439-025-03723-0 

Article Title

Equestrian STAR: Development of an Experimental Methodology for Assessing the Biomechanical Performance of Equestrian Helmets

Article Publication Date

28-Apr-2025