CHICAGO — A recent study by Northwestern Medicine reveals a concerning rise in severe maternal health issues and birth complications in Illinois between 2016 and 2023. The study links these trends to increases in chronic conditions affecting pregnancy, such as high blood pressure, gestational diabetes, mental health disorders, and particularly obesity, which saw the largest annual rise.
The study also highlights significant racial and socioeconomic disparities. Non-Hispanic Black mothers experienced more than double the rate of severe complications compared to non-Hispanic white mothers. Additionally, living in high-poverty neighborhoods heightened maternal health risks for all racial groups.
“Despite recent statewide quality improvement efforts, these outcomes are worsening for all age groups, reflecting the declining health of the reproductive-age population in Illinois,” said Dr. Mugdha Mokashi, the study’s corresponding author and a resident physician at Northwestern’s McGaw Medical Center.
The findings, published on Nov. 21 in Obstetrics & Gynecology Open, mirror national trends showing a rise in conditions like obesity, hypertensive disorders, and gestational diabetes among pregnant people of all ages.
“Our findings highlight how social factors like race and income contribute to disparities in maternal health. To reduce maternal morbidity, efforts must address both racial inequalities and economic hardships,” said Dr. Lynn Yee, a co-author and associate professor at Northwestern University Feinberg School of Medicine.
Study Overview
The study analyzed 988,480 births at 127 Illinois hospitals from January 2016 to June 2023. It found that the overall rate of severe maternal morbidity rose from 1.4% in 2016 to 2% in 2023. Vaginal birth complications increased by 22.4%, and cesarean birth complications rose by 48.9%.
Hypertensive disorders of pregnancy and anemia, both of which increased during the study period, were significant risk factors for severe complications. The most notable rise was in obesity rates, which jumped from 7.8% in 2016 to 22.3% in 2023. Other increases included gestational diabetes (4.2% to 5.5%), depression (2.5% to 6.6%), anxiety (3.1% to 10.4%), and other chronic conditions (4.7% to 7.4%). Non-Hispanic Black patients had a severe maternal morbidity rate of 2.6%, more than double that of non-Hispanic white patients at 1.1%.
Importance of Preconception Counseling
The study’s authors emphasize the importance of preconception counseling for women thinking about pregnancy. Screening for chronic conditions before conception can help optimize health prior to pregnancy.
“Pre-conception counseling is essential to ensure health conditions are well-managed before pregnancy,” said Dr. Mokashi. “There are many public health initiatives in Illinois that can help.”
Not Just Age-Related
The study also found that the increase in health issues and complications is not simply due to an aging population. Even younger mothers, particularly those under 30, showed an increase in chronic conditions like obesity, hypertension, and gestational diabetes.
“Even young pregnant patients are experiencing more medical issues and complications,” Dr. Mokashi noted.
Potential Solutions
The authors suggest that policies aimed at reducing poverty, such as Illinois’ proposed refundable child tax credit (House Bill 4917), could improve maternal health. Perinatal quality initiatives in California, which have reduced postpartum hemorrhage-related morbidity, provide a model for similar efforts in Illinois. The Illinois Perinatal Quality Collaborative is working to reduce cesarean births and address racial disparities through initiatives like Promoting Vaginal Birth and Birth Equity.
Increasing access to doula support and patient navigator programs could also help. In 2024, the Illinois Department of Healthcare and Family Services adjusted reimbursement for doula services. Northwestern’s research into patient navigator programs has shown promise in reducing care disparities, particularly for low-income, minoritized patients postpartum.
At the federal level, the Black Maternal Health Momnibus Act, reintroduced in 2023, includes 13 bills aimed at improving maternal health, including funding for data collection and prevention initiatives.
By addressing these chronic health conditions and improving access to care, the study’s authors argue that maternal health outcomes in Illinois can be improved.
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