Complications in pregnancy jumped during pandemic
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Giving birth became measurably riskier during the pandemic, as factors causing complications — from obesity and diabetes to mental health issues — rose 20% between 2020 and 2023, according to a FAIR Health analysis shared first with Axios.
Why it matters: The findings, gleaned from a database of roughly 47 billion commercial insurance claims, bring into better focus the COVID-era spike in pregnancy complications that not only contributed to the maternal mortality crisis but also drove up health costs.
What they found: Potential complications of pregnancy and delivery tended to rise with age, from 16.7% of patients under age 18 to 43.3% of patients aged 40 and over in 2023.
- The average age at delivery rose 1% over the period studied, to 31.7. It varied sharply by state, from a high of 34.7 in the District of Columbia to a low of 28.2 in Arkansas.
Between the lines: The most common potentially complicating factor was obesity, seen in one in five deliveries in 2023.
- Other conditions included gestational diabetes (11%), pre-existing hypertension (6.5%) gestational hypertension (6.2%), and preeclampsia (2.2%).
- Potential complications rose steadily from 28.4% percent of patients in 2020 to 34% in 2023, for a 19.8% percent increase. Mental health disorders, either preexisting or arising during pregnancy, rose 52.9% percent and were seen in more than 18% of patients in 2023.
The overall median allowable costs for patients with potential complications topped $20,600 in 2023, compared to roughly $16,700 in pregnancies with no potential complications.
- In each year studied, potential complications added 24% or more to the median total allowed for all services rendered, increasing as the age of the patient increased.
The big picture: Maternal mortality in the U.S. has outpaced other developed nations and is particularly acute among Black women and women in rural areas.
- The Biden administration this year proposed standards that would require the hospital industry to invest billions in maternity care improvements in order to remain in Medicare.
