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Pregnant woman.Pregnancy-Related Illness

Approximately 6 million pregnancies occur each year in the United States. Although maternal death is the most extreme adverse pregnancy outcome, a much greater number of women are affected by pregnancy-related complications or morbidities, such as hemorrhage, ectopic (tubal) pregnancy, pregnancy-induced hypertension, infection, and depression. Maternal morbidity is defined as any physical or psychological condition resulting from pregnancy that has an adverse affect on the woman’s health. Maternal morbidities may result in hospitalization or in outpatient treatment and management, or they may never come to the attention of the health care system.

Previous work examining pregnancy-related illness relied predominantly on large computerized hospital discharge data systems, either national or state-based, which provided basic administrative data as well as ICD codes for inpatient diagnoses and procedures. However, the delivery of health care has changed and hospitalizations for pregnancy-related complications have decreased markedly. Neither complications nor disparities in complications can be fully addressed because data sources, such as hospital discharge systems, are inadequate and do not reflect care provided in settings other than hospitals. Several projects are underway in CDC to address challenges associated with measuring and reducing pregnancy-related illness.

Peripartum Cardiomyopathy
Cardiomyopathy (CM) is a disease of heart muscle (myocardium), which can cause heart failure. A special type of CM, peripartum cardiomyopathy (PPCM), is unique to pregnant or recently pregnant women. The etiology is unclear, though it is likely to be associated with the interaction of several factors.  Diagnostic criteria for PPCM are: 1) the development of cardiac failure in the last month of pregnancy or 5 months post-partum; 2) no recognizable heart disease prior to then; 3) no identifiable cause of heart failure; and 4) left ventricular dysfunction.

CDC has funded and is collaborating with university researchers and clinicians to explore establishing a state-based cohort of women with PPCM. This population-based study would enlist clinicians and echocardiography labs, as well as link birth records with hospital discharge records, to better understand this high-risk condition of pregnancy.

Pregnancy-Related Depression
It is estimated that 13% of postpartum women experience depression.  Depression has significant effects on women’s relationships, their ability to nurture their newborn, and their overall quality of life. Effective treatments exist for depression, but because many women are unaware of their depression or because of the social stigma of depression, many women do not disclose their symptoms to their medical provider.

The U.S. Preventative Services Task Force recommends screening adults for depression in clinical practices that have systems in place to assure accurate diagnosis, effective treatment, and follow-up. Because depression screening and treatment issues are different for pregnant and lactating women than in non-pregnant populations, the findings from primary care clinics serving non-pregnant patients may not apply to pregnant and postpartum populations, and there are no clear recommendations for screening during pregnancy or the postpartum period. However, there is evidence that routine depression screening of women in obstetric or in pediatric settings is feasible and will increase the detection of depression and referrals for services.

Scientists in CDC are collaborating with PRAMS states, university researchers, and a large managed care organization in several projects to determine optimal ways to screen women for pregnancy-related depression with the goal of developing and enhancing strategies to reduce its incidence and impact.

Selected Resources

Preconception Care
Preconception care is recognized as a critical component of health care for women of reproductive age …more

Preconception Care (March of Dimes)
http://www.marchofdimes.com/professionals/preconception.asp*

Division of Reproductive Health's Maternal Health, Infant Health, and Preterm Delivery
In the United States each year, approximately six million women become pregnant. While most women have a normal term pregnancy and deliver a normal infant, a safe and healthy pregnancy is not the experience of all women ...more

Smoking During Pregnancy
Smoking during pregnancy is the single most preventable cause of illness and death among mothers and infants.

Reducing Tobacco Use
Since 1987, the Division of Reproductive Health (DRH) has conducted research and surveillance on tobacco use and pregnancy. DRH collaborates with researchers from the Office on Smoking and Health, National Center for Environmental Health, and the National Center for Birth Defects and Disabilities.

PRAMS and Postpartum Depression
Postpartum depression is an important maternal and child health concern that affects the emotional well being of mothers, as well as marital relationships, mother-infant bonding, and infant behavior ...more

Safe Motherhood: Promoting Health for Women Before, During, and After Pregnancy 2008, At A Glance
CDC continues to focus on monitoring pregnancy-related deaths and complications, identifying effective prevention strategies, research to improve maternal and child health, and assisting state health departments to improve programs for women and infants ...more

Maternal and Child Health Journal Special Issue; The Social Context of Pregnancy for African-American Women Abstracts
The journal outlines results of qualitative and quantitative research to identify potential new risk factors for adverse pregnancy outcomes.

Maternal and Child Health Journal Special Issue; Safe Motherhood in the United States Abstracts
The journal outlines some of the major research, health care practice, and policy issues pertaining to safe motherhood.

International Surveys
Reproductive health surveys collect data on maternal and infant health in developing
countries ..more

Pregnancy

Wildfires: Information for Pregnant Women and Parents of Young Infants

National Diabetes Education Program (NIH)

Listeriosis and Pregnancy (USDA)

Questions and Answers About Breastfeeding (National Women's Health Information Center)

Parvovirus B19 Infection and Pregnancy
Parvovirus B19 is a virus that commonly infects humans; about 50% of all adults have been infected sometime during childhood or adolescence ...more

Group B streptococcal disease (GBS)
GBS is a type of bacterium that causes illness in newborn babies, pregnant women, the elderly, and adults with other illnesses, such as diabetes or liver disease. It is the most common cause of life-threatening infections in newborns ...more

Having a Healthy Pregnancy
A woman can take some actions that increase her chance of having a healthy baby. 

Healthy Pregnancy Information (National Women's Health Information Center)

Medication Use During Pregnancy and Breastfeeding
Many pregnant women or mothers who are breastfeeding worry about whether to take medications …more

Pregnancy, Diabetes, and Women's Health
Some women have diabetes only when they’re pregnant. This condition, which is called gestational diabetes, can be controlled just like other kinds of diabetes.

STDs and Pregnancy
Women who are pregnant can become infected with the same STDs as women who are not pregnant. Pregnancy does not provide women or their babies any protection against STDs …more

Postpartum Depression Fact sheet (National Women's Health Information Center)
Also available in Spanish

Guidelines for Vaccinating Pregnant Women

Immunization and Pregnancy Flyer

Immunization Action Coalition*
The Immunization Action Coalition works to increase immunization rates and prevent disease by creating and distributing educational materials for health professionals and the public …more.

Immunizations for Women*
Patient education information from the American College of Obstetricians and Gynecologists (ACOG).

Publication on Maternal and Infant Health

Related Resources

Prevention of Pertussis, Tetanus, and Diphtheria Among Pregnant and Postpartum Women and Their Infants. Recommendations of the Advisory Committee on Immunization Practices (ACIP) Source: MMWR 2008;57(Early Release):147.

Source: MMWR 2007 / 56(50);1312–1316.

Preconception and Interconception Health Status of Women Who Recently Gave Birth to a Live-Born Infant—Pregnancy Risk Assessment Monitoring System (PRAMS), United States, 26 Reporting Areas, 2004 Source: MMWR 2007;56(SS10);1–35.

QuickStats: Percentage of All Live Births by Cesarean Delivery—National Vital Statistics System, United States, 2005 Source: MMWR 2007;56(15):373.

Use of Dietary Supplements Containing Folic Acid Among Women of Childbearing Age—United States, 2005 Neural tube defects (NTDs) are serious birth defects of the spine (spina bifida) and brain (anencephaly), affecting approximately 3,000 pregnancies each year in the United States. Source: MMWR 2005;54(38);955–958.

Recommended Adult Immunization Schedule—United States, October 2006—September 2007 The Recommended Adult Immunization Schedule has been approved Source: MMWR 2006;55(40);Q1Q4.

Revised Recommendations for HIV Testing of Adults, Adolescents, and Pregnant Women in Health-Care Settings The recommendations address HIV testing in health-care settings only Source: MMWR 2006; 55(RR14);117.

Recommendations to Improve Preconception Health and Health Care—United States.
This report provides recommendations to improve both preconception health and care.
Source: MMWR 2006;55(RR06):1–23.

Use of Dietary Supplements Containing Folic Acid Among Women of Childbearing Age—United States, 2005 Neural tube defects (NTDs) are serious birth defects of the spine (spina bifida) and brain (anencephaly), affecting approximately 3,000 pregnancies each year in the United States.
Source: MMWR 2005;54(38):955–958.

HIV Testing in Health-Care Settings

Emerging infectious disease outbreaks: old lessons and new challenges for obstetrician-gynecologists.
This article summarizes a review of literature on three recent disease outbreaks: SARS, West Nile virus, and anthrax. The article highlights the need for obstetricians and gynecologists to keep current with new information about emerging infectious disease threats. This message is especially important to these physicians, given their role as primary healthcare providers for women. American Journal of Obstetrics and Gynecology 2006;194(6):1546–1555.

The Magnitude of Maternal Morbidity During Labor and Delivery, United States, 1993–1997
More than 40% of U.S. women experience some type of complication during childbirth, beyond what would be expected in a normal delivery ...more

CDC's Office of Genomics
Provides information about human genomic discoveries and how they can be used to improve health and prevent disease. It also provides links to CDC wide activities in public health genomics across the lifespan …more

CDC's Pediatric Nutrition Surveillance System (PedNSS) and the Pregnancy Surveillance System (PNSS)

Achievements in Public Health, 1900-1999: Healthier Mothers and Babies
This report summarizes trends in reducing infant and maternal mortality in the United States, factors contributing to these trends, challenges in reducing infant and maternal mortality, and provides suggestions for public health action for the 21st century. Source: MMWR, October 1, 1999 / Vol. 48 / No. 38.

Links to non-Federal organizations found at this site are provided solely as a service to our users. These links do not constitute an endorsement of these organizations or their programs by CDC or the Federal Government, and none should be inferred. The CDC is not responsible for the content of the individual organization Web pages found at these links.
 

 

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Page last reviewed: 5/15/08
Page last modified: 5/15/08
Content source: Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion

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Programs & Campaigns

PRAMS
A surveillance project of CDC and state health departments. PRAMS collects state-specific, population-based data on maternal attitudes and experiences prior to, during and immediately following pregnancy.

MCH EPI
The Maternal and Child Health Epidemiology Program provides financial and technical support to states, and in some cases, time-limited assignments of senior epidemiologists to state maternal and child health programs.

"Back to Sleep" Campaign
Placing babies on their backs to sleep reduces the risk of Sudden Infant Death Syndrome (SIDS), also known as "crib death."

DES Campaign
Diethylstilbestrol (DES) is a drug once prescribed during pregnancy to prevent miscarriages or premature deliveries.

Safe Motherhood Initiative*
The Safe Motherhood Initiative is a global effort that aims to reduce deaths and illnesses among women and infants, especially in developing countries.

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