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Why are pregnancy-related deaths in the U.S. skyrocketing?

The United States faces an alarming public health crisis: pregnancy-related deaths are increasing at a staggering rate. A new study from Northwestern Medicine challenges widely held assumptions about the causes, prompting urgent action.

While other developed nations show declines in maternal mortality, the U.S. is tragically heading in the opposite direction.

It’s easy to assume that rising maternal ages play a primary role in increasing risks. After all, pregnancy comes with greater complications as people get older.

However, the Northwestern study uncovered a startling truth: maternal mortality is increasing across every age group. The most significant increases are occurring in the 25-34 age range.

“Older maternal age is an important risk factor in maternal mortality, but our findings highlight the need to learn what else is causing these rates to accelerate in more recent years, especially in younger adults less than 35 years old.” explained study co-author Dr. Sadiya Khan.

Between 2014 and 2021, the average maternal age in the U.S. saw a slight increase from 28.3 to 29.4 years old. This modest shift seems small, yet during those same years, the overall maternal mortality rates nearly doubled, rising from 16.5 to 31.8.

Of particular concern, the most substantial jump (from 18.9 to 31.8) occurred most recently between 2019 and 2021.

While the Northwestern study doesn’t pinpoint the root causes of this surge, understanding maternal health requires a closer look at pre-existing conditions.

Prior research, including Dr. Khan’s, highlights cardiovascular disease (hypertensive disorders, heart failure, and stroke) as major contributors to poor maternal health outcomes.

“It is critical that we understand what the causes of death are and how we can prevent them, as maternal deaths are largely preventable,” Dr. Khan emphasizes.

What makes pregnancy riskier?

Besides maternal age, numerous factors contribute to pregnancy complications:

Pre-existing health conditions

Entering pregnancy with diseases like diabetes, hypertension, or obesity can worsen during pregnancy. They could lead to complications for both mother and child.

Access to quality care

Barriers to accessing prenatal care can lead to undiagnosed or poorly managed health issues, increasing risks during pregnancy.

Mental health

Depression, anxiety, and stress during pregnancy have been linked to adverse outcomes.

Data Challenges

It’s been difficult to accurately track pregnancy-related deaths in the U.S. To rectify this, a pregnancy checkbox was added to death certificates in 2003, but several states did not adopt it immediately.

The Northwestern study addresses this by analyzing data from states using the checkbox consistently, revealing the troubling trend despite potential limitations.

“While there are limitations with data capture from death certificates, they remain our best source for tracking this public health crisis,” noted Dr. Khan.

Tackling maternal deaths

While this study clarifies the acceleration of maternal mortality rates, a deeper dive into racial disparities is needed. Black individuals are three times more likely to die from pregnancy-related causes.

Tackling this disparity is crucial, which Dr. Khan highlights as a critical focus for future studies.

“While some states, like Illinois, have maternal mortality review committees, we also need better national infrastructure and surveillance programs to review and address the root causes of this maternal health crisis,” explained Dr. Khan.

The findings of this study should sound an alarm. Maternal deaths in the U.S. are increasing rapidly, a trend that impacts women of all ages.

Prioritizing research into the underlying causes, investing in preventative care, and addressing racial disparities are vital steps to protect the health and well-being of mothers nationwide.

The study is published in the American Journal of Preventive Medicine.


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