WIP 49 - Maternal Multimorbidity and Neonatal Health Outcomes in the United States

Poster Number: WIP 49
Publication Number: WIP 49.2518

Background: In the US, maternal mortality rates are twice as high as in similar high-income countries, and adverse pregnancy outcomes (APOs) affect 17-20% of pregnancies. These issues are more common among non-White and lower socioeconomic status patients. A potential factor in high APO rates is maternal multimorbidity, defined as having two or more chronic medical conditions at the time of pregnancy. Understanding the impact of maternal multimorbidity on neonatal outcomes is vital, as the relationship between maternal health conditions and neonatal well-being remains unknown, despite known disparities in maternal health and pregnancy outcomes.

Objective: To investigate the association between multimorbidity and adverse pregnancy outcomes in both pregnant individuals and their newborns in the US.

Design/Methods: This study has received approval from the IRBs of each state department of health and The Children’s Hospital of Philadelphia. We will conduct a retrospective cohort study, analyzing all births in five states from 2000-2020. Our dataset includes birth certificates merged with infant death certificates and maternal and infant hospital discharge records from one year before and after birth, employing deterministic and probabilistic matching methods.

The primary exposure of interest is multimorbidity among birth givers, defined as the concurrent presence of two or more health conditions in mothers. My primary outcome measures will encompass various adverse pregnancy outcomes, including hypertensive disorders of pregnancy, severe maternal morbidity, maternal mortality, and infant outcomes like infant mortality, preterm birth, complications of preterm birth, and unexpected complications of term birth. Logistic and Poisson regression models will assess the association between multimorbidity and these outcomes, adjusting for sociodemographic and health-related factors. We will also employ causal mediation analyses using the techniques of Vanderweele to understand the impact of multimorbidity on observed differences in these outcomes based on race/ethnicity and insurance status.