Study Reveals Hypertension Drives Alarming Rise in Severe Maternal Complications

Comorbidities and Complications: A Growing Maternal Health Challenge

A recent large-scale study published in Obstetrics & Gynecology spotlights a troubling trend: severe maternal morbidity (SMM)—life-threatening complications during childbirth—has become increasingly common in the United States. The study, examining over 25 million hospital deliveries between 2016 and 2022, reveals a sharp increase in SMM rates, with key underlying causes identified.

The Numbers Tell a Story

SMM prevalence rose from 1.5% to 2.2% over the study period.

Nontransfusion SMM (a stricter measure) jumped from 0.7% to 1.0%.

Factors on the rise: hypertensive disorders of pregnancy (from 9.8% to 16.6%), chronic hypertension (1.4% to 2.6%), and obesity (9.7% to 15.4%).

What’s Driving the Increase?

Researchers used sophisticated statistical tools to untangle which maternal risk factors were fueling this surge. Their findings were clear: hypertensive disorders of pregnancy accounted for more than one-third of the total rise in severe maternal morbidity—and over half of the rise when focusing on nontransfusion cases. Chronic hypertension and obesity also played significant roles, while advanced maternal age and gestational diabetes contributed less than previously assumed.

Why Does It Matter?

These discoveries are more than just numbers. They signal a pressing need for preventive health strategies targeting women’s cardiometabolic health—before, during, and after pregnancy. Simple interventions, like better blood pressure management, healthier diets, increased physical activity, and careful monitoring in pregnancy, could make a real difference. Low-dose aspirin and close observation for at-risk pregnancies are also recommended.

Beyond the Clinic: Social and Systemic Factors

The study notes that not all of the rise in SMM can be explained by medical conditions alone. Social determinants of health, access to quality maternity care, and systemic issues like racism and bias may also play a part. Addressing these broader forces is crucial for real progress.

Key Takeaways:

Severe maternal morbidity is steadily rising in the U.S., with hypertensive disorders as the leading driver.

Obesity and chronic hypertension are also major contributors to the problem.

Advanced maternal age and gestational diabetes play a smaller role than previously thought.

Preventive care—before, during, and after pregnancy—is essential to reverse these trends.

Broader societal and healthcare system changes are needed to fully address the crisis.

Citation:

Kawakita T, Jones SA, Furukawa N, Saade G. Contribution of Comorbidities and Pregnancy Complications to Severe Maternal Morbidity in the United States. Obstetrics & Gynecology. 2026;147:877–84. doi:10.1097/AOG.0000000000006214