Breaking News
March 21, 2019 - Mutations in noncoding genes could play big role in regulating cancer, study finds
March 21, 2019 - A medical student’s thoughts on Match Day
March 21, 2019 - Are eggs good or bad for you?
March 21, 2019 - New analysis reveals precision oncology insights for colorectal cancer
March 21, 2019 - Pollutants appear to weaken immune system and increase pathogen virulence
March 21, 2019 - Researchers develop and validate scale for rating severity of mononucleosis
March 21, 2019 - Scientists identify generation of key immune response in mice on introducing solid food
March 21, 2019 - New nanomaterial could restore internal structure of damaged bones
March 21, 2019 - Selective destruction of prostate tumor as effective as complete prostate removal
March 21, 2019 - 2011 to 2015 Saw Increase in Psychiatric ED Visits for Youth
March 21, 2019 - Tapeworm drug targets common vulnerability in tumor cells
March 21, 2019 - Off the beaten path for global health residency
March 21, 2019 - European Parliament’s report calls on EU to develop policies to regulate endocrine-disrupting chemicals
March 21, 2019 - Women with undiagnosed diabetes in pregnancy more likely to experience stillbirths
March 21, 2019 - Fish consumption can help prevent asthma, study reveals
March 21, 2019 - Royal Holloway professors to lead new to research into curing Neurofibromatosis type 1
March 21, 2019 - NSF offers grant to improve treatment approaches for pelvic organ prolapse
March 21, 2019 - Your Apple Watch Might Help Spot a Dangerous Irregular Heartbeat
March 21, 2019 - Research team uncovers critical new clues about what goes awry in autistic brains
March 21, 2019 - From March Madness to medicine with help from mentors
March 21, 2019 - Mental health disorders among young adults may be on the increase
March 21, 2019 - New study examines smarter automatic defibrillator
March 21, 2019 - UC Riverside research shows how natural selection favors cheaters
March 21, 2019 - Mother’s diet during pregnancy can impact lung-specific genes of her offspring
March 21, 2019 - AeroForm Tissue Expanders makes breast reconstruction after mastectomy more comfortable
March 21, 2019 - New project focuses on creating more responsive, intuitive prosthetics
March 21, 2019 - New case study describes adolescent patient with rapid-onset schizophrenia and Bartonella infection
March 21, 2019 - Umass Amherst food scientist honored with 2019 Young Scientist Research Award
March 21, 2019 - Smell of skin could lead to early diagnosis for Parkinson’s
March 21, 2019 - Difference in brain connectivity may explain autism spectrum disorder
March 21, 2019 - Untangling the microbiome — with statistics
March 21, 2019 - Human microbiome metabolites enhance colon injury by enterohemorrhagic E. coli, study shows
March 21, 2019 - Written media can improve citizens’ understanding of palliative care
March 21, 2019 - New research aims to find how asthma symptoms are aggravated
March 21, 2019 - New $9.7 million NIH grant project seeks to improve hearing restoration
March 21, 2019 - Researchers measure brain metabolite levels in people with mild memory problems
March 21, 2019 - FDA approves first drug for treatment of postpartum depression in adult women
March 20, 2019 - Gene editing and designer babies experiments face global moratorium
March 20, 2019 - Major scientific study of wound care dressings wins ‘Best Clinical or Preclinical Research Award’
March 20, 2019 - Biohaven Enrolls First Patient In Phase 3 Generalized Anxiety Disorder (GAD) Trial Of Troriluzole
March 20, 2019 - Big data study identifies drugs that increase risk of psychosis in youth with ADHD
March 20, 2019 - Mystery novel and dream spur key scientific insight into heart defect | News Center
March 20, 2019 - Study measures impact of policies designed to reduce air pollution in two mega-cities
March 20, 2019 - Mild sleep apnea during pregnancy changes sugar levels and may affect infant growth patterns
March 20, 2019 - SSB and Novasep collaborate to develop new membrane chromatography systems
March 20, 2019 - Leaky valve repair improves quality of life in heart failure patients
March 20, 2019 - Diattenuation Imaging offers structural information of difficult to access brain regions
March 20, 2019 - Early sports specialization linked to increased injury rates during athletic career
March 20, 2019 - Study brings clarity about milk intake for children with Duarte galactosemia
March 20, 2019 - Allergan Announces FDA Acceptance of New Drug Application for Ubrogepant for the Acute Treatment of Migraine
March 20, 2019 - Maternal smoking during pregnancy increases risk of ADHD among offspring up to three-fold
March 20, 2019 - Pioneering pediatric kidney transplant surgeon Oscar Salvatierra dies at 83 | News Center
March 20, 2019 - F.D.A. Approves First Drug for Postpartum Depression
March 20, 2019 - TB remains a major public health challenge in the European region
March 20, 2019 - Most pills contain common allergens, warn experts
March 20, 2019 - Researchers discover previously unknown mechanism by which cells can sense oxygen
March 20, 2019 - World’s leading source of data on diagnosis, treatments for aortic dissection
March 20, 2019 - Breast cancer relapse predictor may soon be a reality
March 20, 2019 - Researchers identify origin of chronic pain in humans
March 20, 2019 - Two-drug combinations containing calcium channel blocker significantly lowers BP
March 20, 2019 - King’s scientists to monitor air quality exposure of 250 children
March 20, 2019 - Active substance from plant could turn into a ray of hope against eye tumors
March 20, 2019 - Preventative cardioverter defibrillator implantation is of little benefit to kidney dialysis patients
March 20, 2019 - New method based on neurofeedback may reduce anxiety
March 20, 2019 - Study explores whether alcohol consumption can have an effect on arthritis
March 20, 2019 - Merck to collaborate with GenScript for plasmid and virus manufacturing in China
March 20, 2019 - FDA Approves Zulresso (brexanolone) for the Treatment of Postpartum Depression
March 20, 2019 - Study examines long-term opioid use in patients with severe osteoarthritis
March 20, 2019 - Retired Stanford professor Edward Rubenstein, pioneer in intensive care medicine, dies at 94 | News Center
March 20, 2019 - Aaron Diamond AIDS Research Center to Join Columbia University
March 20, 2019 - Call for halt to human gene editing and designer babies experiments
March 20, 2019 - Study illuminates how hot spots of genetic variation evolved in the human genome
March 20, 2019 - Roundworm study suggests alternatives for treatment of schizophrenia
March 20, 2019 - Sphingotec reports new applications of bio-ADM at 39th ISICEM
March 20, 2019 - Preventing falls through free community-based screenings for older adults
March 20, 2019 - AAOS: Supplement Use Low in Patients With Osteoporosis, Hip Fracture
March 20, 2019 - Does intensive blood pressure control reduce dementia?
March 20, 2019 - Nut consumption could be key to better cognitive health in older people
March 20, 2019 - Drinking hot tea associated with increased risk of esophageal cancer
March 20, 2019 - Androgen receptor plays vital role in regulating multiple mitochondrial processes
Increasing rates of chronic conditions putting more moms, babies at risk

Increasing rates of chronic conditions putting more moms, babies at risk

image_pdfDownload PDFimage_print
Credit: CC0 Public Domain

Pregnant women today are more likely to have chronic conditions that could cause life-threatening complications than at any other time in the past decade – particularly poor women and those living in rural communities, a new Michigan Medicine study suggests.

Using a national sample of 8.2 million childbirth deliveries over 10 years, researchers analyzed the prevalence of common chronic conditions—including asthma, diabetes, hypertension, heart disease, and substance-abuse disorders.

Although frequency of these conditions increased over time among every socio-economic group studied, the largest spikes occurred among women from rural and low income communities and among patients with deliveries funded by Medicaid.

The findings were published in The Green Journal, the official publication of the American College of Obstetricians and Gynecologists.

“Chronic conditions that increase the risk of adverse health outcomes for moms and their newborns are increasingly prevalent among childbearing women,” says lead author Lindsay Admon, M.D., an obstetrician-gynecologist at Michigan Medicine and clinician-scholar at the University of Michigan’s Institute of Healthcare Policy and Innovation.

“Historically, the leading causes of maternal morbidity and mortality in the U.S. have been related to delivery, such as infection or hemorrhage. For the first time in our country, we are seeing complications from pre-existing conditions causing the most harm.”

The research stems from stunning reports over recent years finding that the U.S. continues to defy global trends as one of the only developed countries with a rising maternal mortality rate. The most common cause of maternal death in the country is now complications occurring as a result of a mother’s pre-existing, chronic condition (such conditions are attributed to half of all maternal deaths in the U.S.)

Michigan researchers identified at least one chronic condition among 10 percent of women delivering babies in 2013-14 (92 per 1,000 hospitalizations). That’s an increase of nearly 40 percent from 2005-06 (when it was 67 per 1,000).

Though less common, cases involving multiple pre-existing, chronic conditions increased from 5 to 8 per 1,000 deliveries over the same period.

“The highest prevalence of chronic conditions tied to maternal morbidity and mortality was identified among already vulnerable populations—those living in rural areas and in the poorest communities,” says Admon.

“These findings highlight stark and growing health disparities in maternal health.”

Among the most concerning trends was the increase in substance-abuse disorders. Among all deliveries in 2005-06, substance abuse was identified in 13 per 1,000 hospitalizations, compared to 20 per 1,000 in 2013-14.

For rural women, that rise was far more dramatic: It increased from 11 to 25 per 1,000 deliveries.

As the nation faces an opioid epidemic, Admon says more resources must be devoted to addressing substance abuse, particularly for childbearing women in rural communities that often do not have the same access to care for substance use disorders as urban areas.

The new study underscores the need to address pre-existing conditions among childbearing women during prenatal care, Admon says. She notes for women who are on Medicaid, which finances half of all births in the United States, insurance coverage usually lasts from conception to 60 days postpartum.

“During prenatal care, we have the unique opportunity to have frequent contact with a patient throughout her pregnancy and postpartum recovery. Ideally, in addition to addressing obstetric care, we can also use this time to help her optimize her long term health,” Admon says. “This is especially important for the growing segment of the population with chronic conditions and among those who may lose insurance coverage between pregnancies.”

Admon notes that having conditions such as diabetes and hypertension under control not only benefits women but their newborns who as a result also are at an increased risk of adverse outcomes, including poor growth, pre-term delivery and stillbirth.

In 2005, 23 mothers per 100,000 live births died from complications related to pregnancy or childbirth in the U.S. In 2015, that number rose to 25. That compares to less than nine deaths per 100,000 births in the United Kingdom and less than 7 in Canada.

“We wanted to better understand the trends, prevalence and socio-economic distribution of chronic conditions among women giving birth in the United States to help providers and policymakers better take care of this population,” Admon says. “In describing what populations are more likely to have certain conditions, we can better understand where interventions may have the most impact.”

Physicians should seek to diagnose and address chronic conditions as early as possible, Admon says.

“As maternal health providers, we need to be aware of the increasing burden of chronic conditions complicating our patients’ pregnancies and deliveries. That means actively screening for these conditions and educating our patients about optimal management both during pregnancy and for the long term,” she says.

“Identifying and managing chronic conditions at the beginning of a pregnancy gives women the best chance of having a healthy pregnancy and the outcome we always strive for—a healthy mom and healthy baby.”


Explore further:
Asthma increases risk of complications during pregnancy and delivery

Provided by:
University of Michigan

Tagged with:

About author

Related Articles