Trends in maternal morbidity before and during pregnancy in California

M. Fridman, L.M. Korst, J. Chow, E. Lawton, C. Mitchell and K.D. Gregory

American Journal of Public Health, 2014, vol. 104, issue S1, S49-S57

Abstract: Objectives. We examined trends in maternal comorbidities in California. Methods. We conducted a retrospective cohort study of 1 551 017 California births using state-linked vital statistics and hospital discharge cohort data for 1999, 2002, and 2005. We used International Classification of Diseases, Ninth Revision, Clinical Modification codes to identify the following conditions, some of which were preexisting: maternal hypertension, diabetes, asthma, thyroid disorders, obesity, mental health conditions, substance abuse, and tobacco use. We estimated prevalence rates with hierarchical logistic regression models, adjusting for demographic shifts, and also examined racial/ethnic disparities. Results. The prevalence of these comorbidities increased over time for hospital admissions associated with childbirth, suggesting that pregnant women are getting sicker. Racial/ethnic disparities were also significant. In 2005, maternal hypertension affected more than 10% of all births to non-Hispanic Black mothers; maternal diabetes affected nearly 10% of births to Asian/Pacific Islander mothers (10% and 43% increases, respectively, since 1999). Chronic hypertension, diabetes, obesity, mental health conditions, and tobacco use among Native American women showed the largest increases. Conclusions. The prevalence of maternal comorbidities before and during pregnancy has risen substantially in California and demonstrates racial/ethnic disparity independent of demographic shifts.

Keywords: age; article; comorbidity; diabetes mellitus; ethnic group; female; health disparity; high risk behavior; human; hypertension; mental disease; obesity; pregnancy; pregnancy complication; prevalence; race; retrospective study; smoking; statistical model; statistics; United States, Age Factors; California; Comorbidity; Continental Population Groups; Diabetes Mellitus; Ethnic Groups; Female; Health Status Disparities; Humans; Hypertension; Logistic Models; Mental Disorders; Obesity; Pregnancy; Pregnancy Complications; Prevalence; Retrospective Studies; Risk-Taking; Smoking (search for similar items in EconPapers)
Date: 2014
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Persistent link: https://EconPapers.repec.org/RePEc:aph:ajpbhl:10.2105/ajph.2013.301583_1

DOI: 10.2105/AJPH.2013.301583

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