A new study conducted by Northwestern Medicine has uncovered a concerning increase in severe maternal health issues and birth complications in Illinois from 2016 to 2023. The research highlights a strong correlation between these complications and the rising prevalence of chronic health conditions during pregnancy, particularly high blood pressure, gestational diabetes, mental health disorders, and notably, obesity, which has seen the most significant annual increase.
The study emphasizes existing racial and socioeconomic disparities, revealing that non-Hispanic Black mothers experience more than double the rate of severe complications compared to their non-Hispanic white counterparts. Additionally, living in high-poverty neighborhoods was found to elevate maternal health risks across all racial groups.
“Despite statewide efforts to improve quality of care, these adverse birth outcomes are worsening for women of all ages, reflecting a decline in the pre-pregnancy health of the reproductive-age population in Illinois,” stated Dr. Mugdha Mokashi, the study’s corresponding author and a resident physician in obstetrics and gynecology at the McGaw Medical Center at Northwestern.
Published on November 21 in the journal Obstetrics & Gynecology Open, the findings align with national trends showing an increasing prevalence of obesity, hypertensive disorders, and gestational diabetes among pregnant individuals of all ages.
“Our findings underscore the significant impact of social determinants of health—such as race and income—on maternal health disparities,” said Dr. Lynn Yee, co-author of the study and an associate professor at Northwestern University Feinberg School of Medicine. “Efforts to reduce maternal morbidity must address both racial inequalities and economic hardships.”
The study analyzed data from 988,480 births at 127 hospitals across Illinois between January 2016 and June 2023. Key findings include:
- The overall rate of severe maternal morbidity rose from 1.4% in 2016 to 2% in 2023.
- Complications from vaginal births increased by 22.4%, while cesarean birth complications surged by 48.9%.
- Significant risk factors for severe maternal morbidity included hypertensive disorders of pregnancy and anemia, both of which increased during the study period.
- The most substantial increase was in obesity rates, which rose from 7.8% to 22.3% over the study timeframe. Other notable increases included gestational diabetes (from 4.2% to 5.5%), depression (from 2.5% to 6.6%), anxiety (from 3.1% to 10.4%), and chronic comorbidities (from 4.7% to 7.4%).
- Non-Hispanic Black mothers had a severe maternal morbidity rate of 2.6%, compared to 1.1% for non-Hispanic white mothers.
The authors emphasize the critical role of pre-conception counseling for individuals considering pregnancy, advising them to consult healthcare providers to screen for chronic conditions.
“Optimizing health conditions prior to pregnancy is essential,” Mokashi noted. “There are many important policy and public health initiatives in Illinois that people may want to explore.”
While the study did not initially aim to address age-related issues, additional analysis indicated that the rising prevalence of maternal health problems and complications is not solely attributable to older maternal age. The data showed an increase in hospital coding for various conditions, including hypertensive disorders, gestational diabetes, and obesity, even among women under 30.
“Even young pregnant patients are experiencing more medical conditions and complications,” Mokashi explained.
The authors suggest that policies aimed at alleviating poverty, such as the proposed refundable child tax credit in Illinois (House Bill 4917), could improve maternal health outcomes. They also highlighted successful perinatal quality initiatives in California that have reduced postpartum hemorrhage-related morbidity.
In Illinois, the Perinatal Quality Collaborative is working to reduce cesarean births and address racial disparities through initiatives promoting vaginal birth and birth equity. Increasing access to doula support and patient navigator programs may also help mitigate disparities. In 2024, the Illinois Department of Healthcare and Family Services adjusted reimbursement policies for doula services, and research at Northwestern indicates that patient navigator programs can effectively reduce care disparities for low-income minority patients postpartum.
At the federal level, the reintroduction of the Black Maternal Health Momnibus Act in 2023, comprising 13 bills, aims to provide crucial funding for data collection and quality initiatives to prevent maternal morbidity.
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