ArticleEClinicalMedicine2020
Concerning trends in maternal risk factors in the United States: 1989-2018.
Article in EClinicalMedicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 58 papers, 2 of them syntheses that pooled it.
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Who cites it
58 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Global prevalence of multimorbidity during pregnancy: a systematic review and meta-analysis.Reproductive health · 2026Pooled it
- Pregnancy with multiple high-risk factors: a systematic review and meta-analysis.Journal of global health · 2025Pooled it
- Placental hypoplasia and vascular malperfusion are associated with reduced brain volumes in fetal congenital heart disease.Pediatric research · 2026Article
- Noncardiovascular Medical Conditions in the Pregnancy Mortality Surveillance System, 2012-2022.Obstetrics and gynecology · 2026Article
- Grandmother's pregnancy complications and autism spectrum disorders in grandchildren, a California multigenerational cohort study.JCPP advances · 2026Article
- Global burden of autism spectrum disorders among population aged 70 years and older from 1990-2021, with projections to 2040: findings from the Global Burden of Disease Study 2021.Molecular psychiatry · 2026Article
- Health Care Utilization Among Pregnant Women With Pre-existing Kidney Disease: A Retrospective Cohort Analysis.Kidney medicine · 2025Article
- Comorbidities among women presenting for obstetric care in Uganda.BMC pregnancy and childbirth · 2025Article
- Preconception and Prenatal Medicaid Coverage for Medicaid-Insured Births.Journal of women's health (2002) · 2025Article
- Explaining Racial and Ethnic Disparities in Hypertension and Diabetes during Pregnancy in the United States (2016-2022): A Decomposition Analysis.Journal of racial and ethnic health disparities · 2025Article
- Maternal Age Differences in Interpregnancy Interval and Preterm Birth Associations Accounting for Multiple Epidemiologic Biases.Paediatric and perinatal epidemiology · 2025Article
- The rising tide: Trends in induction of labor at term over a 5-year period at a single centre.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2025Observational
- Racial inequities in cesarean use among high- and low-risk deliveries: An analysis of childbirth hospitalizations in New Jersey from 2000 to 2015.Health services research · 2025Article
- Stillbirth rate trends across 25 European countries between 2010 and 2021: the contribution of maternal age and multiplicity.European journal of public health · 2025Article
- A Review of the Diagnosis, Risk Factors, and Role of Angiogenetic Factors in Hypertensive Disorders of Pregnancy.Medical science monitor : international medical journal of experimental and clinical research · 2025Review
- Review
- Ambulatory care utilization in the first 24 months' postpartum by rurality and pregnancy-related conditions: A prospective cohort study from Maine.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2025Article
- Management of cardiopulmonary bypass in pregnancy: challenges and progress in maternal-fetal protection.Frontiers in cardiovascular medicine · 2025Review
- The Trend in Delayed Childbearing Age and Its Potential Impact on Adverse Maternal-Perinatal Outcomes in Developed and Developing Countries: A Narrative Review.Iranian journal of public health · 2025Review
- Novel Role of Pin1-Cis P-Tau-ApoE Axis in the Pathogenesis of Preeclampsia and Its Connection with Dementia.Biomedicines · 2024Review
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIncreased efforts have focused on reducing maternal morbidity and mortality in the United States (US). Hypertensive disorders of pregnancy, chronic hypertension, diabetes mellitus, very advanced maternal age, and grand multiparity are known contributors to various maternal morbidities, as well as maternal mortality. We aimed to evaluate the trends in these risk factors/complications among US pregnancies during the last three decades (1989-2018).
methodsThis is a retrospective study based on the CDC natality database. We calculated the annual prevalence of each risk factor/complication from 1989 to 2018. Joinpoint regression analysis was then used to evaluate the trends. Annual percentage changes (APC) were calculated for each of the segments identified by the joinpoint regression, and average annual percentage changes (AAPC) were calculated for the entire period. Relative risks (RR) comparing the prevalence of each risk factor/complication in 2018 to its prevalence in 1989 were also calculated. Subsequent analyses evaluated the trends of the main risk factors/complications by maternal age groups. Statistical significance was determined at
findingsBetween 1989 and 2018, the prevalence of hypertensive disorders of pregnancy increased by 149% (AAPC 3·2, 95% CI 2·6-3·8), that of chronic hypertension increased by 182% (AAPC 3·7, 95% CI 3·3-4·2), that of diabetes mellitus increased by 261% (AAPC 4·6, 95% CI 4·0-5·2), that of very advanced maternal age increased by 194% (AAPC 3·8, 95% CI 3·6-4·0), and that of grand multiparity increased by 33% (AAPC 1·0, 95% CI 0·8-1·2). Chronic hypertension and diabetes mellitus increased mostly during the past two decades, while hypertensive disorders of pregnancy and grand multiparity increased primarily over the most recent decade. Additionally, women of very advanced maternal age had significantly higher rates of hypertensive disorders of pregnancy, chronic hypertension and diabetes mellitus throughout our study period.
interpretationOur study shows a marked increase in the prevalence of five pregnancy risk factors/complications over the past three decades (1989-2018). This may point to a significant deterioration in the health of US pregnant women, which potentially contributes to both maternal morbidity and mortality.
fundingNone.
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