The number of women who die each year per every 100,000 live births. To classify as maternal-related, the death must be linked to childbirth or the management of the birth. It cannot be due to an accident or another incidental cause. Estimates of the rate vary, but in the United States it ranges from 21 in 2010 (CIA World Factbook), 17.3 in 2013 (U.S. Centers for Disease Control and Prevention) and 14 in 2015 (World Bank). Some other analyses in peer-reviewed journals have estimated an even higher rate. There is also considerable fluctuation between U.S. states, and country-to-country. In 2015, Sierra Leone had the highest rate worldwide, while Greece, Poland, Finland and Iceland had the lowest rate, according to the World Bank.