THE LATEST findings reveal that pregnancy-related mortality in the United States has not improved over the last 20 years, with considerable racial and ethnic disparities persisting. Despite ongoing efforts, the pregnancy-related mortality ratio remains disproportionately high among certain racial groups, with non-Hispanic Native Hawaiian or other Pacific Islander individuals experiencing rates four times higher, non-Hispanic Black individuals three times higher, and non-Hispanic American Indian or Alaska Native individuals twice as high as non-Hispanic White individuals. To better understand these disparities, Maternal Mortality Review Committees (MMRCs) have conducted in-depth analyses of pregnancy-related deaths, including significant contributions from cardiovascular conditions as underlying causes.
Data for this analysis was drawn from MMRC reviews in 32 states between 2017 and 2019, focusing specifically on cardiovascular causes of pregnancy-related deaths. Of 210 total deaths analyzed, 84 were due to cardiomyopathy (CM) and 126 to other cardiovascular conditions (OCVs). A striking 51.2% of CM-related deaths were among non-Hispanic Black individuals, with most cardiovascular deaths occurring in those under 35. Notably, the majority of cardiovascular deaths occurred 43 to 365 days postpartum, underscoring the long-term health risks following pregnancy. In addition, MMRCs identified that over 75% of these cardiovascular-related deaths were preventable, with recommendations for prevention focusing on community care access, improved continuity of care, and greater awareness of symptoms indicating urgent cardiovascular risk.
These findings underscore that while progress has been made in understanding the causes of pregnancy-related cardiovascular mortality, further action is required in clinical practice to address preventable deaths. Key recommendations from MMRCs include expanding access to comprehensive, community-based healthcare services and enhancing care coordination during the critical postpartum period. By implementing these and other targeted interventions, healthcare providers have the opportunity to significantly reduce pregnancy-related cardiovascular deaths, particularly among vulnerable populations. Future efforts should also focus on increasing awareness of cardiovascular warning signs during and after pregnancy and ensuring that healthcare systems prioritize the health needs of diverse populations to reduce mortality disparities.
Reference
Briller J et al. Pregnancy-related mortality due to cardiovascular conditions: Maternal Mortality Review Committees in 32 U.S. states, 2017 to 2019. JACC Adv. 2024;(12_Part_1) 101382.
