Maternal Mortality 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 the mother and infant. Women with gestational diabetes are at increased risk for developing diabetes later in life.1 In 2005, diabetes during pregnancy occurred at a rate of 38.5 per 1,000 live births and was similar across all racial and ethnic groups (data not shown).

Hypertension during pregnancy can also be either chronic in nature or limited to the duration of pregnancy. Severe hypertension during pregnancy can result in preeclampsia, fetal growth restriction, premature birth, placental abruption, and stillbirth.2 Chronic hypertension was present in 10.4 per 1,000 live births in 2005. The rate of pregnancy-associated hypertension was even higher, occurring in 39.9 of every 1,000 live births.

Other illnesses or risk factors during pregnancy can include eclampsia, which involves seizures (usually preceded by a diagnosis of preeclampsia), and cervical insufficiency, which occurs when the cervix opens or dilates before the fetus is full term. All of these conditions are more common among non-Hispanic Black than non-Hispanic White and Hispanic women, and among older mothers. Excessive or insufficient weight gain during pregnancy can also influence birth outcomes. In 2005, 10.7 percent of infants born to mothers who gained less than 16 pounds were low birth weight, compared to 5.9 percent of infants born to women gaining 36 to 40 pounds.

Excessive weight gain (40 or more pounds) may elevate the risk of gestational diabetes, preeclampsia, and large-for-gestational-age babies; more than 20 percent of pregnant women gained more than 40 pounds in 2005 (data not shown).

1 American Diabetes Association. Gestational Diabetes. http://www.diabetes.org/gestational-diabetes.jsp, accessed 04/01/08.
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.

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