Frequent emergency care during pregnancy could signal greater risk for severe maternal morbidity

Pregnant individuals who make frequent visits to the hospital may be at a higher risk of experiencing life-threatening complications during or after pregnancy, a recent study led by Boston University School of Public Health (BUSPH) and Cityblock Health suggests. Published in JAMA Network Open, the study examined data from nearly 775,000 pregnant patients in Massachusetts and found that 31% of them had at least one unscheduled emergency visit to the hospital, with 3.3% having four or more such visits.

The study highlighted that pregnant individuals who had four or more emergency visits were almost 50% more likely to experience severe maternal morbidity (SMM), which includes complications during labor or childbirth that can lead to serious outcomes like aneurysms, eclampsia, kidney and heart failure, and sepsis. Additionally, the research revealed that nearly half of these high-risk pregnant patients visited multiple hospitals for evaluation, making it challenging for hospital-based pregnancy programs to provide consistent treatment and care.

Dr. Eugene Declercq, the lead author of the study and a professor at BUSPH, emphasized the importance of early identification of high-risk pregnant patients to prevent catastrophic outcomes for both mothers and infants. The study utilized data from a statewide database linking unscheduled hospital visits by pregnant patients to births and fetal deaths, showing that patients who sought emergency care multiple times were more likely to experience SMM, especially during the first and last eight weeks of pregnancy.

Furthermore, the researchers observed disparities among patients who made multiple emergency visits, with women under 25, Hispanic and non-Hispanic Black patients, and those with additional health conditions or opioid-related hospitalizations being at higher risk. Dr. Pooja Mehta, the senior author of the study, stressed the need for timely actions addressing root causes and systemic issues to reduce maternal morbidity, particularly among marginalized communities.

The study serves as a call to action for healthcare providers, policymakers, and advocates to address the unmet needs of pregnant patients who rely on emergency care due to structural barriers and systemic racism. By raising awareness of the risks associated with frequent hospital visits during pregnancy, the research aims to improve prenatal care and support for high-risk pregnant individuals, ultimately reducing maternal morbidity rates in the US.

For more information, the study titled “Emergency Care Use During Pregnancy and Severe Maternal Morbidity” can be accessed in JAMA Network Open. The findings underscore the urgent need for proactive measures to identify and support pregnant patients at risk of severe maternal complications, emphasizing the importance of community-based care and early intervention to ensure positive outcomes for both mothers and infants.