Approximately 4.4% of births involve both prematurity and significant complications for the mother, a double challenge often faced.
In a groundbreaking study published in The Journal of Maternal-Fetal & Neonatal Medicine, researchers have shed light on the alarming issue of "dual burden" births - simultaneous occurrences of preterm birth and severe maternal morbidity. The study, supported by the UCSF California Preterm Birth Initiative, funded by Marc and Lynne Benioff, analysed data from all California births from 2007 through 2012, totalling 3.1 million births.
The study found that one out of 270 births in the study had both preterm birth and severe maternal morbidity. Shockingly, Black women were twice as likely to have a "dual burden" birth as White women when controlling for other factors. This disparity, the researchers suggest, could reflect exposure to chronic stress from discrimination and structural inequity.
Premature infants, those born at less than 37 weeks, can experience a range of health issues, including problems with breathing, digestion, heart rate, and development. Mothers can face serious to potentially life-threatening health issues during childbirth, such as serious bleeding, blood clots, heart failure, emergency hysterectomies, and other serious problems.
Dual burden birth experiences for Black families may include disrespectful encounters when engaging reproductive health care services. These complications occur in one of 270 births and have immediate and persistent physical, psychological, social, and financial consequences for families. They may trigger post-traumatic stress disorder (PTSD) for women and their partners.
Black preterm infants are less likely to be referred for developmental follow-up, which could exacerbate the long-term effects of preterm birth. The study also found that several factors were associated with a higher risk of a "dual burden" birth, including cesarean birth, carrying multiples, smoking during pregnancy, being underweight, high blood pressure, and diabetes.
The researchers propose the need for new models of care that explicitly coordinate infant and maternal health care teams and provide proactive support for the family’s transition to home and long-term health. The organization that supported the study, the California Maternal Data Center, emphasizes the need for such proactive and coordinated care for families affected by both preterm birth and severe maternal birth complications.
Audrey Lyndon, the study's lead author, suggests that racial disparities in health outcomes should be considered markers of exposure to racism, where poorer health reflects the exposure to chronic stress from discrimination and structural inequity. NYU Rory Meyers College of Nursing, a global leader in nursing and health, offers various degree programs to prepare the next generation of nursing leaders and researchers who can contribute to addressing these critical issues.
Impaired parent-infant attachment, damaged partner relationships, and prolonged suffering and feelings of failure are potential consequences of dual burden births. As we continue to grapple with these complex health disparities, it is crucial to prioritize research, policy, and care that addresses the root causes and provides holistic support for affected families.
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