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Prevalence of Severe Maternal Morbidity Increased Across Groups

THURSDAY, March 21, 2019 -- From 1997 to 2014, there was an increase in the prevalence of severe maternal morbidity (SMM), with persistent racial/ethnic disparities, according to a study published online Feb. 28 in the Annals of Epidemiology.

Stephanie A. Leonard, Ph.D., from the Stanford University School of Medicine in California, and colleagues used linked birth certificate and delivery discharge records for 8,252,025 Californian births during 1997 to 2014 to examine disparities in SMM prevalence and trends.

The researchers found that the prevalence of SMM increased from 1997 to 2014 by about 170 percent in each racial/ethnic group and was highest in non-Hispanic black women (1.63 percent) and lowest in non-Hispanic white women (0.84 percent). Over time, the magnitude of SMM disparities remained consistent. After adjustment for comorbidities, anemia, cesarean birth, and other maternal characteristics, the adjusted risk for SMM was higher in women who identified as Hispanic, Asian/Pacific Islander, non-Hispanic black, and American Indian/Alaska Native compared with non-Hispanic white women (risk ratios, 1.14, 1.23, 1.27, and 1.17, respectively).

"These findings are informative for research and initiatives aimed at advancing equity in maternal health," the authors write. "In particular, our study supports public health endeavors to consider factors beyond those captured in administrative datasets, including patient-reported measures of stress, structural racism, and cultural congruency between health care providers and patients."

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Posted: March 2019

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