Photo Credit: Serr Novik
Women with a history of severe maternal morbidity during their first delivery have a significantly higher risk of encountering similar complications in subsequent pregnancies.
The following is a summary of “Risk of recurrent severe maternal morbidity: a population-based study,” published in the NOVEMBER 2023 issue of Obstetrics and Gynecology by Ukah, et al.
Severe maternal morbidity serves as a multifaceted indicator reflecting both maternal health and the quality of obstetrical care. However, there remains a lack of understanding regarding the likelihood of encountering recurrent severe maternal morbidity in subsequent pregnancies following a complicated initial delivery. For a study, researchers sought to quantify the potential risk associated with recurrent severe maternal morbidity in subsequent deliveries after an initial complex delivery.
The research discussed a population-based cohort encompassing women who had undergone a minimum of two singleton hospital deliveries spanning from 1989 to 2021 in Quebec, Canada. The primary exposure of interest was the occurrence of severe maternal morbidity documented during the first hospital delivery. The subsequent occurrence of severe maternal morbidity during the second delivery served as the study’s primary outcome. Utilizing log-binomial regression models adjusted for an array of maternal and pregnancy-specific variables, the research team computed relative risks along with their corresponding 95% CIs, juxtaposing women with and without a history of severe maternal morbidity during their initial delivery.
Within the cohort of 819,375 women studied, a notable 43,501 (3.2%) encountered severe maternal morbidity during their first delivery. Comparatively, the rate of recurrent severe maternal morbidity during the subsequent delivery stood at 65.2 per 1,000 for those with prior severe morbidity, as opposed to 20.3 per 1,000 for those without (adjusted relative risk: 3.11; 95% CI: 2.96–3.27). Intriguingly, the risk was even more pronounced among women who grappled with three or more distinct severe maternal morbidity types during their inaugural delivery, presenting an adjusted relative risk of 5.50 (95% CI: 4.26–7.10). Furthermore, women who experienced cardiac complications during their first delivery exhibited the most elevated risk of severe maternal morbidity in subsequent pregnancies.
The findings elucidated that women previously diagnosed with severe maternal morbidity face a substantially heightened risk of encountering similar complications in subsequent pregnancies. Such insights underscored the critical importance of tailored prepregnancy counseling and vigilant maternity care for this demographic in subsequent pregnancies.