Trends in Pregnancy and Delivery: The Intersection of Maternal Age and Health

July 17, 2025

On June 9, FAIR Health presented a poster at AcademyHealth’s 2025 Annual Research Meeting (ARM) in Minneapolis, Minnesota. As the nation’s largest forum for health services research, ARM annually convenes researchers and health policy professionals dedicated to improving health and healthcare outcomes. FAIR Health’s poster, entitled “Trends in Pregnancy and Delivery: The Intersection of Maternal Age and Health,” was based on its September 2024 white paper Giving Birth in the United States: A Study of Commercial Claims.

The poster offered background on the factors that can make a pregnancy high risk, including maternal age, existing physical and mental health conditions, substance use and pregnancy complications such as gestational diabetes, preeclampsia and eclampsia. To investigate recent trends in pregnancy and delivery among the commercially insured population, FAIR Health studied approximately 2.8 million deliveries in an analysis of over 10 billion claim lines with dates of service from January 1, 2020, to December 31, 2023. Comorbidities known to complicate pregnancy and delivery were deemed “potential complications” since their influence could not be verified.

FAIR Health found that the average age of mothers at delivery rose one percent (0.3 years), from 31.4 in 2020 to 31.7 in 2023. During the same period, potential complications of pregnancy and delivery rose 19.8 percent, diagnoses of mental health disorders in pregnant women rose 52.9 percent and diagnoses of substance use disorders increased 8.2 percent. The most common potential complication in 2023 was obesity (occurring in connection with 19.7 percent of deliveries).

Potential complications tended to rise with age, with 16.7 percent of patients under age 18 having potential complications in 2023, compared to 43.3 percent of patients aged 40 and over. Mental health disorders, however, were most common in mothers under age 18, and substance use disorders were most common in the age groups under age 25 (under 18 and 18 to 24).

In each year from 2020 to 2023, the median total allowed amount for all medical services for patients with potential complications of pregnancy and delivery (including the postpartum period) was at least 24 percent higher than the median total allowed amount for patients with no potential complications.

The poster concluded that maternal age influenced comorbidities in different ways. Older mothers were more likely to experience potential complications of pregnancy and delivery, while younger mothers were more likely to have mental health and substance use disorders. Potential complications increased health system costs. Policy makers could use these findings to inform measures to reduce maternal morbidity—for example, to target maternal obesity and behavioral health conditions.

The poster sparked discussion. Visitors to the poster asked about the data source, FAIR Health’s repository of commercial healthcare claims; remarked about trends in maternal age and health conditions, especially mental health; and suggested follow-up studies, such as investigating the impact of fertility treatment on these trends.