Maternal Morbidity and Risk Factors in Pregnancy
Since 1989, diabetes and hypertension have been the most commonly reported health conditions among pregnant women. Diabetes, both chronic and gestational (developing only during pregnancy), may pose health risks to both a woman and her baby. Women with gestational diabetes are at increased risk for developing diabetes later in life.1 In 2006, diabetes of any type during pregnancy occurred at a rate of 42.3 per 1,000 live births. This varied by race/ethnicity; Hispanic mothers were more likely to have had diabetes (43.0 per 1,000 live births) than non-Hispanic Whites and non-Hispanic Blacks (40.1 and 37.1 per 1,000, respectively).
Hypertension during pregnancy can also be either chronic in nature or gestational. Severe hypertension during pregnancy can result in preeclampsia, fetal growth restriction, premature birth, placental abruption, and stillbirth.2 Chronic hypertension was present in 10.8 per 1,000 live births in 2006, and most common among non-Hispanic Black women (21.0 per 1,000). The rate of pregnancy-associated hypertension was 39.1 per 1,000 live births and was more common among non-Hispanic Black and non-Hispanic White women (46.1 and 43.8 per 1,000 births) than among Hispanic women (28.0 per 1,000).
Eclampsia, which involves seizures and is usually preceded by a diagnosis of preeclampsia, is a life-threatening complication of pregnancy. In 2006, eclampsia occurred among 2.5 women per 1,000 live births.
Rates of maternal morbidities and risk factors also varied by maternal age. In 2006, women aged 40–54 years were at highest risk of diabetes during pregnancy (94.3 per 1,000 live births), pregnancy-associated hypertension (50.5 per 1,000) and chronic hypertension (30.4 per 1,000). Women under 20 years of age were least likely to have diabetes during pregnancy or chronic hypertension (13.3 and 3.9 per 1,000, respectively). Rates of pregnancy-associated hypertension did not vary significantly between age groups for women under 40 years of age.
1 American Diabetes Association. Gestational Diabetes. http://www.diabetes.org/gestational-diabetes.jsp, accessed 03/03/09.↑
2 U.S. Agency for Healthcare Research and Quality. Evidence Report/Technology Assessment Number 14: Management of chronic hypertension during pregnancy. Publication #00E011; Aug 2000.↑