ANN ARBOR – While efforts have been focused on reducing severe complications during and directly following childbirth, new research suggests that these risks may persist for a year postpartum.
Researchers at the University of Michigan found that Black mothers and mothers with depression or anxiety are more susceptible to longer-term risk following birth.
For the study, the research team analyzed the cases of more than 100,000 commercially insured individuals from a national data sample up to one year after they had given birth.
They found that nearly 1 in 333 women had “near miss” experiences that could have been fatal.
“In the U.S. we still view postpartum health as confined to issues occurring in the first few weeks after birth,” lead author Lindsay Admon, an obstetrician-gynecologist and researcher at University of Michigan Health Von Voigtlander Women’s Hospital said in a statement. “But alarming data is emerging showing increasing rates of maternal mortality later in the first year postpartum.
“We need to acknowledge that recovery from childbirth and associated health issues can develop much later than the period of time that we’ve historically focused on.”
According to previous research, at least 70,000 women experience unexpected outcomes that have severe short- or long-term health implications each year during and after labor or delivery in the United States.
The new study focuses on the incidences of these high-risk events that occur six week postpartum, which include needing mechanical ventilation or having a heart attack.
Per 10,000 women, Black women had a 44.3% chance of experiencing harmful health events more than six weeks postpartum compared to white women, who had a 28.9% risk.
Behavioral conditions, substance use disorders and cardiovascular disease contributed to adverse health events following birth, according to maternal mortality review committee data.
The researchers found that women with perinatal anxiety and mood disorders were roughly six times more likely to encounter “near misses.”
“We found persistent racial and ethnic disparities in rates of severe maternal morbidity in the late postpartum period as well as very high rates among individuals with perinatal mood and anxiety disorders,” senior author Kara Zivin, professor of psychiatry and obstetrics and gynecology at the University of Michigan said in a statement.
“To improve outcomes through targeted interventions and policies, we need to find more comprehensive ways to capture the full picture of what drives maternal mortality and morbidity throughout the first year after pregnancy.”
Appropriate, timely care could have helped outcomes in certain populations, said the authors.
“Improving our understanding of the burden and impact of severe maternal morbidity will help us develop strategies to prevent these often tragic outcomes and improve postpartum care to help moms, babies, and their families,” Admon said in a statement.