Complications from cardiovascular disease account for one-third of U.S. pregnancy-related deaths every year. Over 75% of those deaths could be prevented through early detection and better health care, a new report from the National Academies of Sciences, Engineering and Medicine says.
“Too often, opportunities are missed when care is fragmented, follow-up ends too early or women are not connected to ongoing preventive care,” Tracy Lieu, MD, MPH, chair of the report committee and a research scientist at Kaiser Permanente Northern California, said in a news release. “We need to strengthen prevention and continuity of care before, during and after pregnancy.”
Hypertension is a major contributor to pregnancy-related deaths. Medically lowering higher blood pressure during pregnancy and monitoring after delivery when it naturally spikes could prevent complications and deaths, according to "Clinical Preventive Services for Addressing Cardiovascular Disease Risk to Reduce Pregnancy-related Deaths Among Women," which was released April 21.
Lowering and controlling blood pressure would go a long way toward preventing deaths, and is an easy intervention for communities and health systems to undertake immediately.
Given the risk for health issues during postpartum, when most deaths and health issues occur, elevating care for a year following delivery also makes sense, the committee said.
“While we have very clear systems and protocols in place for pregnancy care, that starts to fall apart after delivery,” committee member Kathryn Lindley, MD, director of the Vanderbilt Health Women's Heart Center, said in a news release. "And that's where we really need to think about broader programming to ensure that we don't have those care gaps.”
Improvements to maternal care and social services would also help reduce heart-related complications, the committee said. Among the needs are strengthening care coordination, expanding telehealth and offering comprehensive affordable insurance.
Other barriers to care that need to be addressed are child care expenses, lack of transportation, access to paid time off and telehealth. The committee encouraged advocates to seek legislation and policies addressing the issues as well as efforts to make insurance more affordable.
Nearly 650 maternal deaths occurred in the U.S. in 2024, with Black women and people over 40 disproportionately impacted. Besides cardiovascular disease, other underlying causes of death include severe bleeding, embolism and suicide or homicide.
- Copyright The Nation’s Health, American Public Health Association
