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Comment by jcfrei | Hacker News Reader

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.

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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.

>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://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/

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

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.

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.

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.

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).

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.

Unless there's some threshold in how obesity relates to risk factors that such a small percentage still crossed.

Every year the average age goes up (in these times), with that is higher risk.

"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.

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/PMC9905103/

Covid itself (and flu) have the same effects on the heart (and other things) as well.

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).

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.

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.

Covid virus during pregnancy increases risk of bad outcomes dramatically, but a lot of patients have the wrong (reverse) idea, and therefore refuse the vaccine. Refusing the vaccine is probably a contributing factor. (Source: wife is OB).

This study was looking at data between 2014 - 2021. COVID and the related vaccines are inconsequential to the data presented.

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