Maternal morbidity: a longitudinal study of women's health during and up to 22 months after pregnancy in Jamaica

Psychol Health Med. 2020 Jul;25(6):687-702. doi: 10.1080/13548506.2019.1691243. Epub 2019 Nov 24.

Abstract

Our study evaluated factors associated with ill-health in a population-based longitudinal study of women who delivered a singleton live-born baby in a 3-month period across Jamaica. Socio-demographics, perception of health, chronic illnesses, frequency and reasons for hospital admission were assessed. Relationships between ill-health and maternal characteristics were estimated using log-normal regression analysis. Of 9,742 women interviewed at birth, 1,311 were assessed at four stages, 27.7% of whom reported ill-health at least once. Hospitalization rates were 20.9% during pregnancy, 6.1% up to 12 months and 0.5% up to 22 months after childbirth. Ill-health, reported by 11% of women, was less likely with better education (RR=0.62, 95%; 0.42-0.84). Hospital admission was associated with higher socio-economic status (RR=1.33, 95% 1.04-1.70) and Caesarean section [CS] (RR=1.57, 95%; 1.21-2.04). One in three (33.7%) women reported chronic illnesses, and the likelihood increased with age, parity and delivery by elective CS (RR=1.44, 95%; 1.20-1.73). In multivariable analyses, ill-health was more likely with chronic illness (RR=2.06, 95%; CI: 1.71-2.48) and hospital admission from 12 to 22 months after childbirth (RR=1.54, 95% CI: 1.12-2.12). Ill-health during pregnancy and after childbirth represent a significant burden of disease and requires a standardised comprehensive approach to measuring and addressing this disease burden.

Keywords: Indicators; assessment; maternal morbidity; postnatal; pregnancy.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Cesarean Section / statistics & numerical data*
  • Chronic Disease
  • Educational Status
  • Female
  • Hospitalization / statistics & numerical data*
  • Humans
  • Jamaica / epidemiology
  • Longitudinal Studies
  • Maternal Health*
  • Morbidity
  • Multivariate Analysis
  • Parity
  • Parturition
  • Postpartum Period
  • Pregnancy
  • Pregnancy Complications / epidemiology
  • Prenatal Care
  • Puerperal Disorders / epidemiology*
  • Risk Factors
  • Social Class*
  • Women's Health
  • Young Adult