Perinatal & Pediatric
Pattern of maternal chronic conditions among stillbirth pregnancies Anne Marie Darling* Anne Marie Darling Darling Darling Darling Darling Darling Darling Darling Darling Massachusetts Department of Public Health
Background: Several maternal chronic conditions have been linked to stillbirth, but most research has examined them individually. Patterns of co-occurrence may reflect distinct etiologic pathways, yet they remain poorly characterized. Identifying chronic condition clusters may help guide future etiologic research on stillbirth and clinical care.
Objective: To estimate the prevalence of maternal chronic conditions among women with pregnancies ending in stillbirth enrolled in the Birth Defects Study to Evaluate Pregnancy exposureS (BD-STEPS), and to identify distinct chronic condition profiles.
Methods: We estimated the prevalence of 23 chronic conditions, as well as the occurrence of multiple chronic conditions (≥2 conditions) and complex multimorbidity (≥3 conditions across ≥3 body systems), among 366 BD-STEPS participants whose pregnancies ended in a stillbirth and were unaffected by birth defects. We used latent class analysis (LCA) to identify chronic condition profiles among those reporting ≥2 conditions. We selected the final model based on statistical fit criteria and clinical interpretability.
Results: A majority of women (58.2%, 95% CI 53.1-63.2) reported multiple chronic conditions. Nearly one third (31.1%, 95% CI 26.4, 35.9) met the criteria for complex multimorbidity. Among those reporting ≥2 conditions (n=213), LCA identified two distinct classes of chronic conditions based on modal posterior assignment. The larger class (69%) was characterized by a moderate burden of cardiometabolic conditions and a lower burden of mental health conditions while the smaller class (31%) was characterized by a high burden of mental health conditions and a relatively lower burden of cardiometabolic conditions.
Conclusion: Maternal chronic conditions appear to commonly co-occur among women with pregnancies ending in stillbirth. LCA identified subgroups reflecting differing frequencies of cardiometabolic and mental health conditions. Future research could help determine whether these chronic condition phenotypes are associated with stillbirth risk.