Stress Takes Toll in Very Complicated Births

A "dual burden" of serious maternal complications and premature birth occurs in about one in 270 births, a new study finds.

But hospital staff are often blind to the stress caused by this double whammy, researchers say.

"The situation of combined maternal and newborn complications is likely to be extremely stressful for families concerned for both the mother's and the infant's heath. However, health care providers may not fully recognize this, especially when maternal and newborn care are delivered by different specialists," said study lead author Audrey Lyndon, of New York University College of Nursing.

"There's not enough attention to the combined effect on the family," Lyndon, the assistant dean for clinical research, said in a university news release.

For the study, researchers examined data on all 3.1 million births in California from 2007 through 2012. The investigators found that rates of preterm birth were 876 per 10,000 births, and rates of serious maternal complications during childbirth were 140 per 10,000 births.

One-quarter of women with serious maternal complications also had their babies prematurely. The majority of these dual burden births occurred in cases of preterm labor (61%) rather than births that needed to occur early for medical reasons (23%).

Serious maternal complications during childbirth include severe bleeding that requires a blood transfusion, blood clots, heart failure and emergency hysterectomies. Premature infants -- those born before 37 weeks' gestation -- have a number of health challenges. These may include breathing, digestive and developmental problems.

Black mothers were twice as likely as white mothers to have dual burden births. Other factors associated with higher risk were cesarean-section delivery, having more than one baby, smoking during pregnancy, being underweight, high blood pressure and diabetes.

The study was published online in the Journal of Maternal-Fetal & Neonatal Medicine.

Previous studies have found associations between premature birth and serious maternal complications, but this is the first to examine rates of dual burden births, according to the researchers.

Dual burden births have immediate and long-term physical, mental, social and financial consequences for women and their families. These include the risk of post-traumatic stress disorder for mothers and their partners, the study authors said.

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