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Heart Disease Is the Leading Cause of Maternal Death in the US

Gradually, we’re becoming more aware of heart disease symptoms in women and recognizing that it’s not a condition that only affects men. But more than that, it’s not only older women who are impacted by cardiovascular events; in fact, heart failure is now the leading cause of maternal morbidity in the United States.

Between 1987 and 2011, the rate of pregnancy-related deaths more than doubled, with heart failure being the leading cause of the deaths. Despite that, we still don’t know a lot about heart failure-related hospitalizations before, during and after delivery.

However, a recent study out of the University of Illinois at Chicago is shedding some light on the subject and found that women are at the highest risk for heart failure within the six weeks after delivery. Published in the journal Circulation: Heart Failure, the research also suggests that heart failure is a major health problem among relatively young reproductive-age people who could become pregnant, especially among those who have another existing condition, like high blood pressure.

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“This finding lends support to using delivery-related hospitalization as a window of opportunity to identify high-risk women and develop surveillance strategies before discharge,” Dr. Mulubrhan Mogos, assistant professor of nursing at UIC and the study’s lead author, said in a statement.

Even though less than 2 percent of all pregnancy-related hospitalizations occurred during the postpartum period — six weeks after the delivery — almost 60 percent of pregnancy-related heart failure hospitalizations took place during the same time, the study found.

One of the main takeaways from the study is the need for closer monitoring of high-risk people who have given birth before they are released from the hospital and during the rest of the postpartum period, Mogos said. Normally, people are discharged from the hospital two or three days after giving birth, and their overall health isn’t evaluated until an appointment with their doctor six weeks later.

The rates of heart failure also increased almost 5 percent each year between 2001 and 2011 during the period prior to delivery. According to Mogos and colleagues, this may be attributable, at least in part, to the existence of other conditions (like diabetes or high blood pressure) prior to pregnancy.

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In the study, Black women from the southern United States were more likely to be diagnosed with heart failure both before and after childbirth. For many, pregnancy and childbirth may be their primary access to health care. As a response, Mogos and his coauthors suggested at-risk mothers should be more closely observed after giving birth, ideally by a multidisciplinary team that includes heart-failure specialists.

“Health education about expectations and their risk status during delivery-related hospitalization may empower women to seek immediate support from their social network and healthcare provider,” Mogos said. “There is a need for increased awareness and public health measures to address risk factors and promote prevention strategies among historically disadvantaged groups.”

The moral of the story is that you’re never too young to pay attention to your heart health — especially during pregnancy and after childbirth.

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