Contribution of Maternal Age to Increasing Severe Maternal Morbidity During Birth and Up to 1 Year Postpartum.

IF 2.5 2区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Samuel H Nyarko, Lucy T Greenberg, Scott A Lorch, Jeannette Rogowski, Jeffrey S Buzas, Ciaran S Phibbs, George R Saade, Molly Passarella, Nansi S Boghossian
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引用次数: 0

Abstract

Purpose: We examined whether increasing severe maternal morbidity (SMM) rates are driven by changes in maternal age distribution or age-specific SMM rates.

Methods: In a retrospective cohort study across three states, we analyzed data from two time points (2008-2009 to 2019-2020). We used Kitagawa decomposition analysis to determine the contributions of changes in maternal age distribution and age-specific SMM rates to SMM rates both with and without transfusion during birth and up to 1 year postpartum, stratified by race/ethnicity. We examined the following racial/ethnic groups: non-Hispanic white, non-Hispanic Black, Hispanic, and non-Hispanic Asian/Pacific Islander.

Results: Between 2008-2009 and 2019-2020, SMM and non-transfusion SMM rates increased from 213.6 to 260.5 and from 109.6 to 154.8 per 10,000 births, respectively. Across all racial and ethnic groups, the proportion of younger birthing individuals (<25 years) decreased and the proportion of older individuals (≥30 years) increased. The decomposition analysis showed that increases in SMM and non-transfusion SMM were primarily due to increases in age-specific SMM rates (100.0% and 94.6%, respectively), particularly among younger birthing individuals. Changes in maternal age distribution had a minimal overall contribution. However, when stratified by race/ethnicity, changes in maternal age distribution had a greater contribution to SMM (28.9%) and non-transfusion SMM (22.7%) rates among non-Hispanic Black individuals, with little to no contribution observed in the other groups.

Conclusion: The increasing rates of birth-related and postpartum SMM rates stem from increasing rates of SMM in every age group rather than shifts in maternal age distribution.

产妇年龄对分娩期间和产后1年内严重产妇发病率增加的贡献。
目的:我们研究了严重产妇发病率(SMM)的增加是否由产妇年龄分布或年龄特异性SMM率的变化驱动。方法:在一项横跨三个州的回顾性队列研究中,我们分析了两个时间点(2008-2009年至2019-2020年)的数据。我们使用Kitagawa分解分析来确定母亲年龄分布和年龄特异性SMM率的变化对分娩时和产后1年输血和不输血的SMM率的贡献,并按种族/民族分层。我们研究了以下种族/民族群体:非西班牙裔白人、非西班牙裔黑人、西班牙裔和非西班牙裔亚裔/太平洋岛民。结果:2008-2009年至2019-2020年期间,SMM和非输血SMM率分别从每万例新生儿213.6例上升到260.5例,从109.6例上升到154.8例。结论:出生相关和产后SMM率的上升源于每个年龄组SMM率的上升,而不是母亲年龄分布的变化。
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来源期刊
CiteScore
4.50
自引率
6.20%
发文量
97
审稿时长
32 days
期刊介绍: Women"s Health Issues (WHI) is a peer-reviewed, bimonthly, multidisciplinary journal that publishes research and review manuscripts related to women"s health care and policy. As the official journal of the Jacobs Institute of Women"s Health, it is dedicated to improving the health and health care of all women throughout the lifespan and in diverse communities. The journal seeks to inform health services researchers, health care and public health professionals, social scientists, policymakers, and others concerned with women"s health.
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