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At about 2.40am on Sunday, a Commodore sedan and a Hyundai sedan collided on Newcastle Road at North Lambton, after police allegedly had tried to pull the Commodore over.
A passenger in the Hyundai, a 55-year-old woman, died at the scene.
A 28-year-old woman, who was driving the Hyundai, was taken to hospital where she remains in a serious condition.
Police were later told the woman had been pregnant and lost her unborn child following the crash.
Two teenage girls, aged 15 and 17, who were in the back seat of the Commodore, were taken to hospital where they also remain in a serious condition.
Police allege the driver and front-seat passenger of the Commodore fled the scene before officers arrived.
Police arrested a 19-year-old man at a home in Mayfield, Newcastle, yesterday afternoon.
He was charged with multiple offences including dangerous driving causing death.
The Wallsend man was refused bail and will appear in court later today.