Health, not age, drives increase in pregnancy complications
Mothers are aging, but that doesn’t make pregnancies more risky
Increased rates of adverse pregnancy outcomes, such as hypertensive disorders, preterm birth, and low birth weight, over the past 10 years are largely attributed to a person’s health status before becoming pregnant, rather than from to age, according to a study presented at the Annual Scientific Session of the American College of Cardiology in conjunction with the World Congress of Cardiology.
The study found that the average age of pregnant people increased from 27.9 years in 2011 to 29.1 years in 2019, but age accounted for only a small part of the marked increase in adverse pregnancy outcomes seen during the same period. Most strikingly, the rate of hypertensive disorders of pregnancy (high blood pressure with or without preeclampsia or eclampsia) increased more than 50% over the decade, although the change in the age distribution of those who gave birth accounted for less than 2 % of that change.
“Although mothers are aging at the time of delivery, that is not what is causing these adverse birth outcomes ,” said Zachary Hughes, MD, an internal medicine physician at Northwestern Memorial Hospital in Chicago and lead author of the study. “What really drives it are pre-pregnancy health problems , such as diabetes and hypertension. It is important to know because these are factors that we could potentially modify.”
Using data from the birth files of the National Center for Health Statistics, researchers compared rates of preeclampsia and eclampsia, premature births, and low birth weight between 3.9 million births in 2011 and 3.7 million births in 2019. The results showed moderate increases in preterm births and low birth weight (which increased by about 2% and 4%, respectively) and larger increases in hypertensive disorders (an increase of 52%). Using statistical methods to analyze the role of age in these changes, the researchers found that the change in age distribution accounted for only a small part of the increase in all outcomes evaluated.
Adverse pregnancy outcomes have important health consequences, including an increased risk of heart disease both at the time of pregnancy and later in life, not only for the person giving birth but also for the baby. The researchers said that preventing these adverse outcomes could help reduce cardiovascular risk throughout each life.
“I hope these findings can lead more toward a cultural shift of focusing on pre-pregnancy health,” Hughes said. “Many people don’t establish care with a doctor until they become pregnant, but really starting six months or a year before you start planning a pregnancy, that’s the time to maximize your health as much as possible and minimize the risk of adverse pregnancy outcomes. pregnancy. “This also suggests that doctors and policymakers could focus more on pre-pregnancy health and controlling things like hypertension and diabetes before someone gets pregnant.”
Across all age groups, people who gave birth in their late teens and early 30s experienced the steepest increases in adverse pregnancy outcomes. More research is needed to determine what specific health problems, such as obesity, diabetes, hypertension or other factors, are causing these pregnancy complications in younger people, the researchers said.
Current medical guidelines recognize pregnancy with anticipated delivery at age 35 or older as a risk factor for adverse outcomes and recommend additional screening and monitoring for these pregnancies. Based on the findings of this new study, the researchers emphasized the importance of doctors and people considering pregnancy, including the youngest, to focus on addressing other health conditions to ensure the best possible chance of a pregnancy and a healthy child. Additionally, people diagnosed with gestational diabetes or high blood pressure during pregnancy should include these conditions as part of their future health history, even if the conditions resolve after birth, as they may lead to an increased risk of disease. heart disease later in life.
Reference : “Association Between Changes in Age Distribution of Birthing Individuals and Adverse Pregnancy Outcomes in the United States, 2011-2019,”
