Pregnancy complications tied to higher risk of death as long as 50 years later

Even decades after delivering pre-term or with conditions like gestational diabetes or high blood pressure, those with complications in pregnancy or birth have a higher risk of death.

Complications from pregnancy and child birth have led to high death rates among people who have given birth in the United States, and a new study using long-range, racially inclusive data shows that these complications can have deadly implications as long as 50 years later. Compared to those who had typical pregnancies and childbirths, patients with conditions like high blood pressure in pregnancy, gestational diabetes, and preterm delivery were all tied to a greater risk of death in the decades following their deliveries, according to a new Circulation study led by a researcher at the Perelman School of Medicine.

Pregnant person laying in a bed with an IV drip in their arm.
Image: iStock/Motortion

“We know that the context of childbirth has changed since the 1950s and ’60s, but these findings demonstrate how crucial it is to people’s long-term health that we invest in preventive care and screenings for people with complicated pregnancies and deliveries, both then and today,” says the study’s lead author, Stefanie Hinkle, an assistant professor of epidemiology at Penn Medicine.

In the United States, more than 800 people die every year giving birth. The latest number show that, out of every 100,000 births, more than 23 result in the death of the person delivering. France’s maternal death rate is the next highest among peer countries, and the United States’ death rate is still three times as high. These figures account for deaths in childbirth and during the immediate postpartum period, but the long-term effects of complicated childbirths—which can lead to serious, lifelong health conditions such as heart disease, diabetes, and more—have often been overlooked.

Hinkle and her co-authors drew on data collected from more than 46,000 people who gave birth at a dozen United States health centers between 1959 and 1966. The patients were tracked for deaths of any kind until 2016, at which time 39%, roughly 18,000, had died.

In their analysis, the researchers found that a pre-term childbirth (a delivery three weeks or more before the due date) due to spontaneous labor was tied to a 7% increase in risk of death compared to those who delivered a baby full-term. The risk climbed to 23% for those whose water broke before term, 31% for preterm induced labor, and actually doubled for patients who had a pre-term caesarean delivery, all compared to those who hadn’t had these types of deliveries.

This story is by Frank Otto. Read more at Penn Medicine News.