A recent study by Northwestern Medicine has identified a significant rise in severe maternal health issues and birth complications in Illinois between 2016 and 2023. The research points to chronic health conditions such as obesity, high blood pressure, gestational diabetes, and mental health disorders as contributing factors.
The study highlights racial and socioeconomic disparities, noting that non-Hispanic Black mothers experienced more than double the rate of severe complications compared to their non-Hispanic white counterparts. Additionally, residing in high-poverty neighborhoods increased maternal health risks across all racial groups.
"Despite significant recent statewide quality-improvement efforts, these birth outcomes are worsening for all ages, reflecting the worsening pre-pregnancy health of the reproductive-age population in Illinois," said Dr. Mugdha Mokashi, corresponding author and resident physician at McGaw Medical Center at Northwestern.
The findings align with national trends showing an increase in obesity, hypertensive disorders of pregnancy, and gestational diabetes among pregnant individuals. The study offers updated data on maternal morbidity and delivery complications within Illinois.
"Our findings underscore the role of social determinants of health — such as race and income — in driving disparities in maternal health," stated Dr. Lynn Yee, co-author and associate professor at Northwestern University Feinberg School of Medicine.
Analyzing data from 988,480 births across 127 hospitals from January 2016 to June 2023 revealed a rise in severe maternal morbidity rates from 1.4% to 2%. Vaginal birth complications rose by 22.4%, while cesarean birth complications increased by 48.9%.
Increases were also observed in hypertensive disorders of pregnancy and anemia during this period. Obesity saw the largest annual rate increase from 7.8% to 22.3%. Gestational diabetes rose from 4.2% to 5.5%, depression from 2.5% to 6.6%, anxiety from 3.1% to 10.4%, along with other chronic comorbidities rising from 4.7% to 7.4%. Non-Hispanic Black patients had a severe maternal morbidity rate more than double that of non-Hispanic white patients (2.6% vs. 1.1%).
Health counseling before pregnancy is deemed crucial by the study authors: "Pre-conception counseling is such an important way to make sure that all of your health conditions are optimized prior to pregnancy," Mokashi emphasized.
Further analysis indicated that the increase in maternal health issues isn't solely due to older age among pregnant individuals but also reflects more hospital coding for various conditions even among those under age thirty.
"In brief, even young pregnant patients have more medical conditions and complications in pregnancy," Mokashi noted.
Potential solutions include policies aimed at poverty alleviation like Illinois' proposed refundable child tax credit (House Bill 4917), which could improve maternal health outcomes if passed.
Initiatives like California's perinatal quality programs have reduced postpartum hemorrhage-related morbidity; similarly, Illinois is working on reducing cesarean births through Promoting Vaginal Birth initiatives aimed at addressing racial disparities.
Enhancing access to doula support services was mentioned as beneficial by Mokashi: In response this year’s adjustment made by Illinois Department Healthcare Family Services regarding reimbursement rates further supports these efforts alongside patient navigator programs shown effective reducing care disparities low-income minoritized populations postpartum federally re-introduced Black Maternal Health Momnibus Act would provide essential funding preventive measures nationwide should Congress pass it next session ###