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Women With Severe Maternal Morbidity Less Likely to Have Subsequent Birth

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Substantially lower probability of subsequent birth seen for those with severe uterine rupture, cardiac complications

By Elana Gotkine HealthDay Reporter

MONDAY, Nov. 25, 2024 (HealthDay News) — Women who experience severe maternal morbidity (SMM) in the first birth are less likely to have a subsequent birth, according to a study published online Nov. 25 in the Journal of the American Medical Association.

Eleni Tsamantioti, M.D., from the Karolinska Institutet in Stockholm, and colleagues examined the association between SMM in a first birth and the probability of a subsequent birth in a retrospective, population-based cohort study conducted among 1,046,974 women in Sweden with a first birth between 1999 and 2021.

Overall, 3.5 percent of women experienced an SMM condition in their first birth. The researchers found that women with any SMM versus those without SMM in their first delivery had a reduced incidence rate of subsequent birth (136.6 versus 182.4 per 1,000 person-years; adjusted hazard ratio, 0.88). Women with severe uterine rupture, cardiac complications, cerebrovascular accident, and severe mental health conditions had a substantially lower probability of subsequent birth (adjusted hazard ratios, 0.48, 0.49, 0.60, and 0.48, respectively). Familial confounding did not influence the associations, as indicated in sibling analyses.

“Adequate reproductive counseling and improved monitoring and antenatal care are crucial for women with a history of SMM,” the authors write.

One author disclosed ties to the Aixial Group.

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