Skip to main content

Advertisement

SpringerLink
Log in

Racial, Ethnic, and Economic Disparities in the Prevalence of Pregnancy Complications

  • Published:
Maternal and Child Health Journal Aims and scope Submit manuscript

Abstract

Objectives Our objective was to use maternal self-reported data to estimate the prevalence of urinary tract infections, placenta disorders, and preterm rupture of the membranes (PROM) and to explore the association between these complications and race, ethnicity, and economic status. Methods We used data for the years 2000–2002 from the Pregnancy Risk Assessment Monitoring System (PRAMS), an ongoing survey of women with a recent live birth, to examine the prevalence of and hospitalizations for self-reported urinary tract infections, placenta disorders, and PROM and to investigate differences by maternal race, Hispanic ethnicity, and economic status. Prevalence and hospitalizations were calculated as a percent of the represented population using SUDAAN to account for the sampling design. Results Urinary tract infections were commonly reported, occurring in more than 17% of women during their pregnancy. Placenta disorders and PROM were each reported by approximately 6% of women. Poverty and race had independent effects on each of the pregnancy complications examined. Fewer than half of the women who experienced these pregnancy complications were hospitalized. Conclusions Pregnancy complications are common and not adequately measured by hospitalizations alone. Both more research and improved surveillance are needed to understand the effect of pregnancy complications on women’s health and the reasons for the increased risk among poor or black women.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Berg, C., Bruce, F. C., & Callaghan, W. M. (2002). From mortality to morbidity: The challenge of the twenty-first century. Journal of the American Medical Women’s Association, 57(173), 174.

    Google Scholar 

  2. Bacak, S. J., Callaghan, W. M., Dietz, P. M., & Crouse, C. (2005). Pregnancy-associated hospitalizations in the United States, 1999–2000. American Journal of Obstetrics and Gynecology, 192(2), 592–597.

    Article  PubMed  Google Scholar 

  3. Bennett, T. A., Kotelchuck, M., Cox, C. E., Tucker, M. J., & Nadeau, D. A. (1998). Pregnancy-associated hospitalizations in the United States in 1991 and 1992: A comprehensive view of maternal morbidity. American Journal of Obstetrics and Gynecology, 178(2), 346–354.

    Article  PubMed  CAS  Google Scholar 

  4. Franks, A. L., Kendrick, J. S., Olson, D. R., Atrash, H. K., Saftlas, A. F., & Moien, M. (1992). Hospitalization for pregnancy complications, United States, 1986 and 1987. American Journal of Obstetrics and Gynecology, 166(5), 1339–1344.

    PubMed  CAS  Google Scholar 

  5. Scott, C. L., Chavez, G. F., Atrash, H. K., Taylor, D. J., Shah, R. S., & Rowley, D. (1997). Hospitalizations for severe complications of pregnancy, 1987–1992. Obstetrics and Gynecology, 90(2), 225–229.

    Article  PubMed  CAS  Google Scholar 

  6. Danel, I., Berg, C., Johnson, C. H., & Atrash, H. (2003). Magnitude of maternal morbidity during labor and delivery: United States, 1993–1997. American Journal of Public Health, 93(4), 631–634.

    Article  PubMed  Google Scholar 

  7. Gazmararian, J. A., Petersen, R., Jamieson, D. J., Schild, L., Adams, M. M., Deshpande, A. D., et al. (2002). Hospitalizations during pregnancy among managed care enrollees. Obstetrics and Gynecology, 100(1), 94–100.

    Article  PubMed  Google Scholar 

  8. Chang, J., Elam-Evans, L. D., Berg, C. J., Herndon, J., Flowers, L., Seed, K. A., et al. (2003). Pregnancy-related mortality surveillance—United States, 1991–1999. Morbidity and Mortality Weekly Report, 52(SS02), 1–8.

    Google Scholar 

  9. Weissman, J. S., Gatsonis, C., & Epstein, A. M. (1992). Rates of avoidable hospitalization by insurance status in Massachusetts and Maryland. The Journal of the American Medical Association, 268(17), 2388–2394.

    Article  CAS  Google Scholar 

  10. Frederiksen, M. C., Glassenberg, R., & Stika, C. S. (1999). Placenta previa: A 22-year analysis. American Journal of Obstetrics and Gynecology, 180(6 Pt 1), 1432–1437.

    Article  PubMed  CAS  Google Scholar 

  11. Ananth, C. V., Demissie, K., Smulian, J. C., & Vintzileos, A. M. (2001). Relationship among placenta previa, fetal growth restriction, and preterm delivery: A population-based study. Obstetrics and Gynecology, 98(2), 299–306.

    Article  PubMed  CAS  Google Scholar 

  12. ACOG committee opinion. (2002) Placenta accreta. Number 266, January 2002. American College of Obstetricians and Gynecologists. International Journal of Gynaecology and Obstetrics, 77(1), 77–78.

    Google Scholar 

  13. Adams, M. M., Harlass, F. E., Sarno, A. P., Read, J. A., & Rawlings, J. S. (1994). Antenatal hospitalization among enlisted servicewomen, 1987–1990. Obstetrics and Gynecology, 84(1), 35–39.

    PubMed  CAS  Google Scholar 

  14. Shulman, H. B., Gilbert, B. C., Msphbrenda, C. G., & Lansky, A. (2006). The pregnancy risk assessment monitoring system (PRAMS): Current methods and evaluation of 2001 response rates. Public Health Reports, 121(1), 74–83.

    PubMed  Google Scholar 

  15. Whitehead, N. S., Callaghan, W., Johnson, C. H., & Williams, L. (2004). Maternal morbidity surveillance: Comparing hospital discharge data, birth certificates and confidential questionnaires. Presented at Society for Pediatric and Perinatal Epidemiology Annual Meeting, Salt Lake City, Utah, 14, June 2004.

  16. Shah, B. V., Barnwell, B. G., & Bieler, G. S. (1996). SUDAAN user’s manual, release 7.0. Research Triangle Park: Research Triangle Institute.

    Google Scholar 

  17. Nicolle, L. E. (2003). Asymptomatic bacteriuria: When to screen and when to treat. Infectious Disease Clinics of North America, 17(2), 367–394.

    Article  PubMed  Google Scholar 

  18. McDermott, S., Szwejbka, L., Mann, H., Durkin, M., & Callaghan, W. (2001). Urinary tract infections during pregnancy in South Carolina. Journal of the South Carolina Medical Association, 97(5), 195–200.

    CAS  Google Scholar 

  19. Schieve, L. A., Handler, A., Hershow, R., Persky, V., & Davis, F. (1994). Urinary tract infection during pregnancy: Its association with maternal morbidity and perinatal outcome. American Journal of Public Health, 84(3), 405–410.

    Article  PubMed  CAS  Google Scholar 

  20. Stenqvist, K., Dahlen-Nilsson, I., Lidin-Janson, G., Lincoln, K., Oden, A., Rignell, S., et al. (1989). Bacteriuria in pregnancy. Frequency and risk of acquisition. American Journal of Epidemiology, 129(2), 372–379.

    PubMed  CAS  Google Scholar 

  21. Kutlay, S., Kutlay, B., Karaahmetoglu, O., Ak, C., & Erkaya, S. (2003). Prevalence, detection and treatment of asymptomatic bacteriuria in a Turkish obstetric population. The Journal of Reproductive Medicine, 48(8), 627–630.

    PubMed  Google Scholar 

  22. Teppa, R. J., & Roberts, J. M. (2005). The uriscreen test to detect significant asymptomatic bacteriuria during pregnancy. Journal of the Society for Gynecologic Investigation, 12(1), 50–53.

    Article  PubMed  Google Scholar 

  23. Akerele, J., Abhulimen, P., & Okonofua, F. (2001). Prevalence of asymptomatic bacteriuria among pregnant women in Benin City, Nigeria. Journal of Obstetrics Gynaecology, 21(2), 141–144.

    Article  CAS  Google Scholar 

  24. Ananth, C. V., Oyelese, Y., Yeo, L., Pradhan, A., & Vintzileos, A. M. (2005). Placental abruption in the United States, 1979 through 2001: Temporal trends and potential determinants. American Journal of Obstetrics and Gynecology, 192(1), 191–198.

    Article  PubMed  Google Scholar 

  25. Lydon-Rochelle, M., Holt, V. L., Easterling, T. R., & Martin, D. P. (2001). First-birth cesarean and placental abruption or previa at second birth(1). Obstetrics and Gynecology, 97(5 Pt 1), 765–769.

    Article  PubMed  CAS  Google Scholar 

  26. Bhide, A., & Thilaganathan, B. (2004). Recent advances in the management of placenta previa. Current Opinions in Obstetrics and Gynecology, 16(6), 447–451.

    Article  Google Scholar 

  27. Chama, C. M., Wanonyi, I. K., & Usman, J. D. (2004). From low-lying implantation to placenta praevia: A longitudinal ultrasonic assessment. Journal of Obstetrics and Gynaecology, 24(5), 516–518.

    Article  PubMed  CAS  Google Scholar 

  28. Guinn, D. A., Goldenberg, R. L., Hauth, J. C., Andrews, W. W., Thom, E., & Romero, R. (1995). Risk factors for the development of preterm premature rupture of the membranes after arrest of preterm labor. American Journal of Obstetrics and Gynecology, 173(4), 1310–1315.

    Article  PubMed  CAS  Google Scholar 

  29. Gardner, M. O., Goldenberg, R. L., Cliver, S. P., Tucker, J. M., Nelson, K. G., & Copper, R. L. (1995). The origin and outcome of preterm twin pregnancies. Obstetrics and Gynecology, 85(4), 553–557.

    Article  PubMed  CAS  Google Scholar 

  30. Ladfors, L., Mattsson, L. A., Eriksson, M., & Milsom, I. (2000). Prevalence and risk factors for prelabor rupture of the membranes (PROM) at or near-term in an urban Swedish population. Journal of Perinatal Medicine, 28(6), 491–496.

    Article  PubMed  CAS  Google Scholar 

  31. Pregnancy-related deaths among Hispanic Asian/Pacific Islander, and American Indian/Alaska Native women-United States, 1991–1997. MMWR Morb Mortal Weekly Report. (2001). May 11, 50(18), 361–4.

  32. Martin, J. A., Hamilton, B. E., Sutton, P. D., Ventura, S. J., Menacker, F., Kirmeyer, S., et al. (2007). Births: Final data for 2005. National Vital Statistics Reports, 56(6), 1–103.

    PubMed  Google Scholar 

  33. Tomeo, C. A., Rich-Edwards, J. W., Michels, K. B., Berkey, C. S., Hunter, D. J., Frazier, L., et al. (1999). Reproducibility and validity of maternal recall of pregnancy-related events. Epidemiology, 10, 771–777.

    Article  Google Scholar 

  34. Buka, S. L., Goldstein, J. M., Seidman, L. J., & Tsuang, M. T. (2000). Maternal recall of pregnancy history: Accuracy and bias in schizophrenia research. Schizophrenia Bulletin, 26(2), 335–350.

    PubMed  CAS  Google Scholar 

  35. Casey, R., Rieckhoff, M., Beebe, S. A., & Pinto-Martin, J. (1992). Obstetric and perinatal events: The accuracy of maternal report. Clinical Pediatrics, 31(4), 200–204.

    Article  PubMed  CAS  Google Scholar 

  36. Olson, J. E., Shu, X. O., Ross, J. A., Pendergrass, T., & Robison, L. L. (1997). Medical record validation of maternally reported birth characteristics and pregnancy-related events: A report from the children’s cancer group. American Journal of Epidemiology, 145(1), 58–67.

    PubMed  CAS  Google Scholar 

  37. Oates, R. K., & Forrest, D. (1984). Reliability of mothers’ reports of birth data. Australian Paediatric Journal, 20(3), 185–186.

    PubMed  CAS  Google Scholar 

Download references

Acknowledgments

We acknowledge the contribution to PRAMS and this work by the PRAMS Working Group: Alabama: Albert Woolbright, PhD; Alaska: Kathy Perham-Hester, MS, MPH; Arkansas: Gina Redford, MAP; Colorado: Alyson Shupe, PhD; Florida: Helen Marshall; Georgia: Carol Hoban, MS, MPH; Hawaii: Limin Song, MPH, CHES; Illinois: Theresa Sandidge, MA; Louisiana: Joan Wightkin; Maine: Martha Henson; Maryland: Diana Cheng, MD; Michigan: Yasmina Bouraoui, MPH; Minnesota: Jan Jernell; Mississippi: Linda Pendleton, LMSW; Montana: JoAnn Dotson; Nebraska: Jennifer Severe-Oforah; New Jersey: Lakota Kruse, MD; New Mexico: Ssu Weng, MD, MPH; New York State: Anne Radigan-Garcia; New York City: Candace Mulready, MPH; North Carolina: Paul Buescher, PhD; North Dakota: Sandra Anseth, RN; Ohio: Amy Davis; Oklahoma: Dick Lorenz; Oregon: Ken Rosenberg, MD, MPH; Rhode Island: Sam Viner-Brown; South Carolina: Sylvia Sievers, PhD; Texas: Tanya J. Guthrie, PhD; Utah: Lois Bloebaum; Vermont: Peggy Brozicevic; Washington: Linda Lohdefinck; West Virginia: Melissa Baker, MA; CDC PRAMS Team, Applied Sciences Branch, Division of Reproductive Health. The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention.

Author information

Authors and Affiliations

  1. RTI International, 2951 Flowers Road, Suite 119, Atlanta, GA, 30341, USA

    Nedra S. Whitehead

  2. Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA

    William Callaghan, Chris Johnson & Letitia Williams

Authors
  1. Nedra S. Whitehead
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. William Callaghan
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Chris Johnson
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Letitia Williams
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Nedra S. Whitehead.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Whitehead, N.S., Callaghan, W., Johnson, C. et al. Racial, Ethnic, and Economic Disparities in the Prevalence of Pregnancy Complications. Matern Child Health J 13, 198–205 (2009). https://doi.org/10.1007/s10995-008-0344-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10995-008-0344-2

Keywords

Search

Navigation