Top Things to Know: Call to Action: Maternal Health and Saving Mothers
Published: September 08, 2021
- Maternal mortality is alarmingly high at about 700 deaths a year in the United States, with 2 out of 3 US pregnancy-related deaths estimated to be preventable.
- The rates of severe maternal morbidity (SMM), which are unexpected outcomes of labor and delivery that impact significant short- or long-term consequences to a woman’s health have also increased almost 200% in the United States over the years, from 49.5 deaths per 10,000 delivery hospitalizations in 1993 to 144.0 per 10,000 delivery hospitalizations in 2014.
- Cardiovascular disease (CVD) is the leading cause of maternal mortality in the US, potentially accounting for more than 1 in 3 pregnancy related deaths.
- Risk factors for CVD in women of childbearing age not only include chronic hypertension, pre-pregnancy obesity, chronic diabetes, hypercholesterolemia, smoking and sedentary lifestyle, but also hypertensive disorders of pregnancy including preeclampsia and gestational hypertension, gestational diabetes mellitus, preterm delivery, small-for-gestational-age neonate, and placental abruption.
- Identification of CVD high-risk factors during pregnancy may set the stage for corrective strategies to improve long-term outcomes, however there is currently no standardized approach for CVD assessment in pregnancy.
- Individuals with cardiovascular risk factors identified in the ante-, intra- and postpartum periods should be actively managed both during and after the pregnancy.
- Pregnancy-related mortality rates for non-Hispanic Black and American Indian/Alaska Native women are up to 2-3 times that of White women, and these disparities persist independent of socioeconomic variables.
- Evidence suggests that structural racism may be a contributor to disparities in maternal outcomes, particularly the disproportionately high rates of maternal mortality among Black women.
- AHA recommends a multi-pronged approach to help reduce US maternal mortality rates, including: improving health literacy and public awareness on preconception care; achieving cultural competency and bias reduction among providers; mitigating the impact of social and structural determinants of health; transforming payment and promoting value-based care; modernizing healthcare delivery infrastructure and expanding care-coordination; improving public health infrastructure and digitally enabled healthcare; improving quality reporting of maternal outcomes and health metrics; and expanding access to quality postpartum care.
- AHA is committed to leveraging advocacy efforts and working with strategic partners to develop sustainable and impactful solutions for preventing maternal death and ensuring all individuals experiencing pregnancy can live healthy lives before, during, and after giving birth.
Citation
Mehta LS, Sharma G, Creanga A, Hameed A, Hollier L, Johnson J, Leffert L, McCullough LD, Mujahid M, Watson K, White C; on behalf of the American Heart Association Advocacy Coordinating Committee. Call to action: maternal health and saving mothers: a policy statement from the American Heart Association [published online ahead of print September 8, 2021]. Circulation. doi: 10.1161/CIR.0000000000001000