Bottom Line: Move over, post-partum hemorrhage, because cardiovascular causes reign supreme! In a new study based on CDC data from 2005-2024, cardiovascular causes were the number one cause of death in pregnancy overall (well, except for COVID…).
Additional Information
This study looked at 20 years of data, based on 14000 deaths recorded in CDC's Pregnancy Mortality Surveillance System and found that cardiovascular causes (which include cardiomyopathy, coronary artery disease, valvular disease, and arrhythmias among others) were the number one over cause of death in pregnancy, causing about a quarter of deaths.
Cardiovascular causes led every five year period from 2005 to 2024 except 2020-2024, when infection/sepsis was number one, primarily because of COVID-19, which personally caused almost 60% of pregnancy deaths secondary to infection/sepsis.
Immediately following cardiovascular causes comes infection/sepsis, which causes around 17.8% overall, then other non-cardiovascular medical causes (12%), and then hemorrhage, at only around 11%.
That's not to say that hemorrhage isn't still a big killer - it is, but it's important for emergency providers to keep in mind that pregnancy doesn't do away with all other diseases - a pregnant patient can have as many non-pregnancy problems as they dang well please, whether that's CAD, kidney disease, PEs, or your good, old-fashioned COVID, so always keep looking!
References
Njie F, Hollier LM, Gibson C, et al. Trends in Pregnancy-Related Mortality in the United States: Pregnancy Mortality Surveillance System, 2005-2024. Obstet Gynecol. Published online August 7, 2026. doi:10.1097/AOG.0000000000006396