Exploring the Dual Burden of Severe Maternal Morbidity and Preterm Birth in California

Summary: 
For most families experiencing preterm birth, the infant(s)’ health will be the main focus. However, for some families whose babies are born too soon, the mother may also be very sick or have very serious health complications. These families face a dual burden of both the infant’s and the mother’s health problems.

Principal Investigators:
Alison El Ayadi, ScD, MPH | Bixby Center for Global Reproductive Health

Background

For most families experiencing preterm birth, the infant(s)’ health will be the main focus. However, for some families whose babies are born too soon, the mother may also be very sick or have very serious health complications. These families face a dual burden of both the infant’s and the mother’s health problems.

Objective

The purpose of this study was to explore how often this dual burden occurs for families in California.

Method

We used records from the State of California that have certain information from the birth certificate and the mother’s hospital stay, but cannot be traced to individuals. This large sample of over 3 million births from 2007-2012 let us look at dual burden which rare compared to the number of births without these complications. We used codes within the hospital records to find cases of dual burden and compare them to other births. We used statistical models that count rare events and adjust for differences between groups. We found that 1 in 270 women have dual burden with childbirth.

Results

The risk of dual burden was higher with cesarean births, high blood pressure and preeclampsia, smoking during pregnancy, and being underweight or having diabetes before pregnancy. Black women had twice the risk of dual burden after accounting for other factors like age, weight, insurance, education, and high blood pressure. Dual burden affects 1900 California families per year. Special attention is needed to understand and meet the needs of these families.

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1 in 270 Births Have “Dual Burden” of Prematurity and Severe Maternal Complications

A population-based study to identify the prevalence and correlates of the dual burden of severe maternal morbidity and preterm birth in California