Maternal Chronic Illness

There are a number of maternal conditions or diseases that place pregnancies and offspring at risk of mortality or morbidity. The United States government, through the Center for Disease Control, collects data on a selected number of these characteristics. Table 6.1 presents this listing and the rates of some of the most important maternal risk factors.

Data in Table 6.1 indicate that of those risk factors that are specifically tracked, anemia (low levels of iron in the blood), diabetes mellitus and risks related to hypertension have the highest rates of occurrence. These risk factors occur at a rate of more than 10 per 1,000, or in more than 1 percent of pregnancies ending in live births. The rates would be higher if calculated for pregnancies as opposed to live births, because it is known that many of these conditions increase risks of spontaneous abortions and stillbirth. There many other medical risks factors that do not occur at sufficient rates to be individually tracked. Categorized as Other Medical Risks, this group accounts for a larger rate of medical risks than all the individually tracked conditions combined.

One of the most striking aspects of the data in Table 6.1 is that the rate of most of the risks factors increased between 1992 and 2002. Further, the greatest increases have been in some of the maternal diseases that affect the largest number of pregnancies. For example, anemia has increased from 18.6 to 26.4 per 1,000 live births, and pregnancyassociated hypertension has increased from 29.3 to 39.3 per 1,000. Some of the risk factors listed have increased more than 30 percent during this 10-year period. Risks due to anemia will be discussed in Chapter 7, and risks due to genital herpes has been alluded to in Chapter 5. This chapter will focus on diabetes, hypertension and lung disease, as well as the role that obesity plays in many of these diseases.