Chapter 3701-66 | Pregnancy Associated Mortality Review

Rule 3701-66-01 | Pregnancy-associated mortality review definitions.

• Effective: October 25, 2021
• Promulgated Under: 119.03

(A) "Chance to Alter Outcome" means the review committee determination whether there was no chance, some chance, or a good chance of the death being averted by one or more reasonable changes to patient, family, community, provider, and / or systems factors.

(B) "Contributing Factor" means other factors beyond the cause and manner of death that may be partly responsible for the woman's death.

(C) "Department or director" means the director of the Ohio department of health or any official or employee of the department designated by the director of the Ohio department of health.

(D) "Pregnancy-associated mortality review (PAMR) Board" means the board established or appointed to review deaths of women, residing in Ohio, while pregnant, or anytime within one year of pregnancy, for the purpose of decreasing the incidence of preventable maternal deaths.

(E) "Pregnancy-associated death" means the death of a woman while pregnant or anytime within one year of pregnancy regardless of cause.

(F) "Pregnancy-related death" means the death of a woman while pregnant or within one year of the end of pregnancy, regardless of duration and physiological site of pregnancy, from any cause related to or aggravated by her pregnancy or its management.

(G) "Pregnancy-associated, but not related death" means the death of a woman while pregnant or within one year of the end of pregnancy, due to a cause unrelated to pregnancy.

(H) "Pregnancy-associated, but unable to determine pregnancy relatedness" means the death of a woman while pregnant or within one year of pregnancy, due to a cause that could not be determined to be pregnancy-related or not pregnancy-related.

(I) "Pregnancy-associated mortality ratio (PMR)" means the number of pregnancy-associated deaths per one hundred thousand live births.

(J) "Pregnancy-related mortality ratio (PRMR)" means the number of pregnancy-related deaths per one hundred thousand live births.

(K) "Pregnancy-associated, but not related, mortality ratio" means the number of pregnancy-associated deaths, that were not pregnancy-related, per one hundred thousand live births.

(L) "Preventable" means the degree to which an individual or community could have reasonably done something that would have changed the circumstances that led to the woman's death.

(M) "Public record" means any record defined in division (A)(1) of section 149.43 of the Revised Code.

(N) "Review" means a general assessment or examination of the death of a woman while pregnant, or anytime within one year of pregnancy. The review shall at least consider the cause of death; manner of death; circumstance of death; contributing factors; age; race and ethnicity; and geographic location of death.

Last updated October 25, 2021 at 11:30 AM

Supplemental Information

Authorized By: 3738.09
Amplifies: 3738.01
Five Year Review Date: 10/15/2026

Rule 3701-66-02 | Confidentiality.

• Effective: October 25, 2021
• Promulgated Under: 119.03

All records, documents, reports, or other information presented to the PAMR board, all statements made by board members during board meetings, all work products of the board, and data submitted to the department of health by the board, other than the biennial reports described in section 3738.08 of the Revised Code are confidential and not a public record per section 3738.06 of the Revised Code.

Last updated October 25, 2021 at 11:30 AM

Supplemental Information

Authorized By: 3738.09
Amplifies: 3738.06, 3738.08
Five Year Review Date: 10/15/2026

Rule 3701-66-03 | Members.

• Effective: October 25, 2021
• Promulgated Under: 119.03

The PAMR board shall assess current board membership for geographic and demographic representation, and areas of expertise concerned with the care of pregnant and postpartum women. Annually, the board will identify gaps or insufficient representation and draft a list of potential new members for consideration. This list shall be provided to the director of health to review and appoint new members.

Last updated October 25, 2021 at 11:30 AM

Supplemental Information

Authorized By: 3738.09
Amplifies: 3738.01
Five Year Review Date: 10/15/2026

Rule 3701-66-04 | Review procedure.

• Effective: October 25, 2021
• Promulgated Under: 119.03

(A) No less than four times per year, the ODH bureau of vital statistics shall provide a preliminary list of names of Ohio resident women who have died within one year of the conclusion of pregnancy to the department PAMR staff. These data will be provided to PAMR no later than one year following the year of death. This list shall include: name of the decedent, date of birth of decedent, date of death of decedent, death certificate number for decedent, birth certificate or fetal death certificates of infant(s) if available.

(B) At least annually, all vital statistics data from death, birth, and fetal death certificates shall be uploaded to the maternal mortality data system.

(C) Upon receipt of list of deaths from vital statistics, PAMR staff shall identify potential sources of medical, social service, law enforcement, coroner and other data related to the case. Staff will request records for review.

(D) Abstractors will review all records and enter case information into the maternal mortality data system. Deidentified case summaries will be produced and distributed to PAMR board members. The board shall meet no less than three times per year to review cases. A committee decision form will be completed following the review of each case. Results from the committee decision form will be entered into the maternal mortality data system.

(E) To the extent available, the board must consider the following information when conducting pregnancy-associated death reviews: age of decedent, race of decedent, ethnicity of decedent, timing of death related to pregnancy (pregnant at time of death; not pregnant, but pregnant within forty-two days of death; not pregnant, but pregnant forty-three days to one year before death), cause of death, manner of death, contributing factors, chance to alter outcome/preventability and recommendations to prevent future deaths.

Last updated October 25, 2021 at 11:30 AM

Supplemental Information

Authorized By: 3738.09
Amplifies: 3738.01
Five Year Review Date: 10/15/2026