Study: Maternal Age and Severe Maternal Morbidity Increase in Canada

For women in Canada, the risk of facing a life-threatening complication during or shortly after pregnancy has risen — especially among women giving birth at an older age, a new analysis shows.

Researchers analyzed 3.1 million pregnancies in Canada between 2004 and 2015, and found that severe maternal morbidity — issues such as postpartum hemorrhage, sepsis and heart failure — rose by 9.8%. Mothers who were 45 or older or were low-income were at the highest risk of suffering from severe maternal morbidity and of dying within six weeks of the end of pregnancy.

Over the 11-year period, where women lived and whether they had an existing health issue, such as drug abuse, sickle cell disease or chronic heart failure, also affected their risk of severe maternal morbidity and mortality, according to the study, published Friday in JAMA Network Open.

“These findings have direct relevance for prospective parents, clinicians, and public health professionals,” researchers from the University of Toronto and elsewhere said.

[READ: Canadian Program Aims to Boost Birth Outcomes for Low-Income Women]

In many high-income countries, including Canada, teen birth rates have plummeted in recent decades, and more women are waiting longer to become mothers. Previous research has shown that across the globe, women over 35 are at higher risk of maternal mortality than younger women, but the extent that maternal age affects women’s health outcomes in Canada has been unclear, the study said.

Overall, Canada saw a severe maternal morbidity rate of 17.7 per 1,000 deliveries over the study period. The country’s maternal mortality rate, meanwhile, was 6.2 per 100,000 deliveries, with postpartum hemorrhage, sepsis and brain and heart issues tied to pregnancy-induced hypertension the most common underlying causes.

“While substantially lower than in the United States, Canada’s maternal mortality rate is greater than that in many high-income countries in Europe,” the study said.

The pregnancy-related death rate in the U.S. — which captures deaths up to a year after childbirth — more than doubled between 1987 and 2015, from 7.2 to 17.2 deaths per 100,000 births, according to the Centers for Disease Control and Prevention. A recent analysis indicates that about 88% of these deaths in the U.S. occur within six weeks postpartum, and that many may be preventable.

[MORE: Canada Seen As One of World’s Best Countries for Women]

It’s difficult to directly compare the two countries, though, because of differences in data collection and definitions, the new study said. But understanding the major causes and risk factors for pregnancy-related death and complications could help health professionals improve maternal health — in Canada and beyond.

For example, ensuring women with high-risk pregnancies are treated at hospitals that are equipped to handle emergencies, as well as detecting and helping women manage other health issues early on in pregnancy, could help reduce their risk of poor outcomes, the study said. Those efforts could be especially key for older women giving birth for the first time.

“The findings of an increasing risk of (severe maternal morbidity) and mortality with increasing maternal age may be one of many important public health and education considerations in the timing of pregnancy across the reproductive lifespan,” researchers said.

More from U.S. News

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What’s Being Done to Fight Maternal Mortality in America?

Report: U.S. Most Dangerous Place to Give Birth in Developed World

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