3 ms·

I'm gonna risk sounding dismissive here but the article very cautiously points at a cause: "While this study wasn’t able to explore specific causes of death, a

by jcfrei 2y ago

I'm gonna risk sounding dismissive here but the article very cautiously points at a cause: "While this study wasn’t able to explore specific causes of death, a large body of prior research, much of it published by Khan, has found cardiovascular disease (hypertensive disorders, heart failure and stroke) is a major contributor to poor maternal health outcomes." Hypertensive disorders are typically associated with obesity so the reason could be that there's an increasing share of pregnancies happening with people who are overweight. I leave the sociodynamic interpretation of this up to the reader.

SamuelAdams 2y ago
Yes it seems odd how the medical community (and American patients in general) don’t really want to talk about obesity anymore. Being obese and carrying a baby to term is risky. Everything is much more complicated. I do wonder if they make the BMI of mothers available in a publicly available dataset somewhere, it would be interesting to test your hypothesis.
- lotsofpulp 2y ago
  >Yes it seems odd how the medical community (and American patients in general) don’t really want to talk about obesity anymore. That is not what it looks like to me. Body mass index (BMI), a proxy for obesity, is a relevant statistic in almost every wellness exam. https://www.cdc.gov/obesity/index.html https://www.cdc.gov/obesity/index.html https://health.gov/healthypeople/objectives-and-data/browse-objectives/overweight-and-obesity https://health.gov/healthypeople/objectives-and-data/browse-... The hottest new medicine is a medicine that reduces obesity. See Novo Nordisk market cap change: https://companiesmarketcap.com/novo-nordisk/marketcap/ https://companiesmarketcap.com/novo-nordisk/marketcap/
tonmoy 2y ago
Obesity rates increased slightly between 2014 to 2021, but I’m not sure that will account for doubling of mortality rate. It could mean that more obese people are having kids than before, but that would be far from trivial to prove
- explorigin 2y ago
  Unless there's some threshold in how obesity relates to risk factors that such a small percentage still crossed.
- _heimdall 2y ago
  I'd first look at the use of assidted fertility treatments (ARTs). I can't find solid data on trends that cover through 2021, but infertility rates and the use of ARTs have both gone up. It seems reasonable that there would be increased risks during a pregnancy when the body wasn't prepared to get pregnant without intervention.
  - michaelt 2y ago
    I'd have expected the opposite, myself. Unplanned pregnancies might happen to people who aren't ready to have a child, physically and mentally - or who don't have easy access to medical care. IVF, in contrast, only produces planned pregnancies, and only in people with easy access to medical care.
    - lostmsu 2y ago
      These days most unplanned pregnancies would probably fall on physical prime as opposed to planned ones. And mental state doesn't really have effect on maternal death rates. I agree with GP that IVF probably provides motherhood to a lot of people who have preexisting medical issues.
    - kyleee 2y ago
      Though unplanned pregnancies may skew young which is probably good for (reduces) infant mortality. IVF on the other hand very likely skews older, and I wonder if those needing IVF are also less healthy on average than non-IVF.
      - _heimdall 2y ago
        This would be my assumption, though I haven't found data on it and frankly it is a pretty politically unpopular topic to research. The human body wants to reproduce as its default state. When it can't, there must be physical or environmental reasons (or the likely rare genetic condition that can be a primary cause of infertility).
the_real_cher 2y ago
Covid vaccines also had a detrimental effect on the heart and menstruation. Theres numerous studies to support that. Not saying its the cause but just saying its one possible cause along with obesity and abortion restrictions if we're throwing theories out there. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9294036/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9294036/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9905103/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9905103/
- michaelmcdonald 2y ago
  This study was looking at data between 2014 - 2021. COVID and the related vaccines are inconsequential to the data presented.
- eagerpace 2y ago
  Covid itself (and flu) have the same effects on the heart (and other things) as well.
- jonpurdy 2y ago
  From the conclusion in the first study: chronic COVID-19 infection may have more adverse effects on the menstrual cycle than COVID-19 vaccines, which have so far presented no long-term adverse events linked to fertility or reproduction So there’s nothing detrimental, just a temporary change (which can happen for many reasons).
  - the_real_cher 2y ago
    A temporary change to menstruation cycle due to an vaccine for a respiratory virus. The studies all conclude that and agree with you but still seems unusual to me.
    - saati 2y ago
      Because respiratory virus is an oversimplification of COVID, yes that's why people die from it, but it affects all cells with ACE2 receptors, for example neurons and blood vessel linings.
cameldrv 2y ago
"with the largest increase of 18.9 to 31.8 occurring from 2019 to 2021." That's gotta be COVID. Could be the virus, could be substandard care due to COVID, but obesity didn't go up that much in two years.

by jcfrei 2y ago

SamuelAdams 2y ago

Yes it seems odd how the medical community (and American patients in general) don’t really want to talk about obesity anymore. Being obese and carrying a baby to term is risky. Everything is much more complicated. I do wonder if they make the BMI of mothers available in a publicly available dataset somewhere, it would be interesting to test your hypothesis.

lotsofpulp 2y ago
>Yes it seems odd how the medical community (and American patients in general) don’t really want to talk about obesity anymore. That is not what it looks like to me. Body mass index (BMI), a proxy for obesity, is a relevant statistic in almost every wellness exam. https://www.cdc.gov/obesity/index.html https://www.cdc.gov/obesity/index.html https://health.gov/healthypeople/objectives-and-data/browse-objectives/overweight-and-obesity https://health.gov/healthypeople/objectives-and-data/browse-... The hottest new medicine is a medicine that reduces obesity. See Novo Nordisk market cap change: https://companiesmarketcap.com/novo-nordisk/marketcap/ https://companiesmarketcap.com/novo-nordisk/marketcap/

tonmoy 2y ago

Obesity rates increased slightly between 2014 to 2021, but I’m not sure that will account for doubling of mortality rate. It could mean that more obese people are having kids than before, but that would be far from trivial to prove

explorigin 2y ago
Unless there's some threshold in how obesity relates to risk factors that such a small percentage still crossed.
_heimdall 2y ago
I'd first look at the use of assidted fertility treatments (ARTs). I can't find solid data on trends that cover through 2021, but infertility rates and the use of ARTs have both gone up. It seems reasonable that there would be increased risks during a pregnancy when the body wasn't prepared to get pregnant without intervention.
- michaelt 2y ago
  I'd have expected the opposite, myself. Unplanned pregnancies might happen to people who aren't ready to have a child, physically and mentally - or who don't have easy access to medical care. IVF, in contrast, only produces planned pregnancies, and only in people with easy access to medical care.
  - lostmsu 2y ago
    These days most unplanned pregnancies would probably fall on physical prime as opposed to planned ones. And mental state doesn't really have effect on maternal death rates. I agree with GP that IVF probably provides motherhood to a lot of people who have preexisting medical issues.
  - kyleee 2y ago
    Though unplanned pregnancies may skew young which is probably good for (reduces) infant mortality. IVF on the other hand very likely skews older, and I wonder if those needing IVF are also less healthy on average than non-IVF.
    - _heimdall 2y ago
      This would be my assumption, though I haven't found data on it and frankly it is a pretty politically unpopular topic to research. The human body wants to reproduce as its default state. When it can't, there must be physical or environmental reasons (or the likely rare genetic condition that can be a primary cause of infertility).

the_real_cher 2y ago

Covid vaccines also had a detrimental effect on the heart and menstruation. Theres numerous studies to support that. Not saying its the cause but just saying its one possible cause along with obesity and abortion restrictions if we're throwing theories out there. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9294036/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9294036/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9905103/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9905103/

michaelmcdonald 2y ago
This study was looking at data between 2014 - 2021. COVID and the related vaccines are inconsequential to the data presented.
eagerpace 2y ago
Covid itself (and flu) have the same effects on the heart (and other things) as well.
jonpurdy 2y ago
From the conclusion in the first study: chronic COVID-19 infection may have more adverse effects on the menstrual cycle than COVID-19 vaccines, which have so far presented no long-term adverse events linked to fertility or reproduction So there’s nothing detrimental, just a temporary change (which can happen for many reasons).
- the_real_cher 2y ago
  A temporary change to menstruation cycle due to an vaccine for a respiratory virus. The studies all conclude that and agree with you but still seems unusual to me.
  - saati 2y ago
    Because respiratory virus is an oversimplification of COVID, yes that's why people die from it, but it affects all cells with ACE2 receptors, for example neurons and blood vessel linings.

cameldrv 2y ago

"with the largest increase of 18.9 to 31.8 occurring from 2019 to 2021." That's gotta be COVID. Could be the virus, could be substandard care due to COVID, but obesity didn't go up that much in two years.