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Women who experience serious complications during child birth more likely to repeat on second birth: Study

According to a study done by the Research Institute of the McGill University Health Centre (RI-MUHC), 1 to 3 per cent of women who give birth in Canada experience serious complications.

Many of these women do want to have additional children but face an added risk of additional complications.

The 32-year-long study found that not only are these women more likely to have complications, but they are also three times more likely to experience any severe maternal morbidity during a second delivery.

Severe maternal morbidity is an unexpected outcome that generally occurs during labour or delivery and has serious short or long-term effects on women’s health and well-being, according to McGill researchers.

“Severe maternal morbidity is linked with maternal mortality and prolonged hospitalization, but until now, little was known about [the] recurrence of severe maternal morbidity in a subsequent delivery,” says Dr. Natalie Dayan, senior author of the study and scientist in the Cardiovascular Health Across the Lifespan Program at the RI-MUHC.

“Our study provides quantitative estimates about maternal complications in a subsequent birth and shows that the risk of recurrent severe maternal morbidity is greatest for women with cardiac complications or uterine rupture at first delivery.”

During the study, researchers looked at a population-based cohort of over 1.4 million pregnant women between 1989 and 2021 in Quebec.

Of those women, roughly 820,000 had at least two single-child deliveries. 25,873, or 3.2 per cent of these women, experienced severe maternal morbidity in their first delivery.

The study found that 65.2 of every 1,000 women who had severe maternal morbidity had it again with their second child. In comparison, 20.3 of every 1,000 women who were fine with their first child had complications with the second.

Researchers also looked into specific complications in the first and second delivery. Women with cardiac complications during their first delivery had the highest risk of severe maternal morbidity in the next delivery. They were roughly seven times higher than women who had no complications.

The study noted any type of complication also led to an increased chance of cardiac complications and severe preeclampsia, a serious blood pressure condition that happens during pregnancy, at a subsequent birth.

In addition, some complications were more likely to happen during a second birth. Those complications include cardiac events, severe preeclampsia or eclampsia, severe hemorrhage and surgical complications.

However, complications like acute renal failure; embolism; shock or disseminated intravascular coagulation, which, according to the Canadian Cancer Society, is a rare condition where the “blood clots too much;” and sepsis, were less likely to reoccur.

“This knowledge will help counsel women about future pregnancy risks, as well as plan and allocate resources to provide care for these women if they do conceive again,” adds Dr. Dayan.

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