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Trends and Racial and Ethnic Disparities in Maternal Cardiovascular Health in California
Elleni M Hailu1, Suzan L Carmichael1, Jonathan M Snowden2
1Division of Neonatology, Department of Pediatrics, School of Medicine Stanford University Palo Alto CA USA.
Journal of the American Heart Association
|September 25, 2025
Summary
Maternal cardiovascular health shows worsening trends and significant racial disparities in the US. Non-Hispanic Black mothers face higher risks of hypertensive disorders, while American Indian/Alaska Native mothers have lower ideal cardiovascular health.
Area of Science:
- Cardiovascular Health
- Maternal Health
- Health Disparities
Background:
- The US maternal health crisis necessitates examination of cardiovascular health trends.
- Racial and ethnic disparities in maternal cardiovascular health require urgent attention.
Purpose of the Study:
- To analyze epidemiologic trends in maternal cardiovascular health.
- To investigate racial and ethnic disparities in hypertensive disorders of pregnancy.
- To assess ideal cardiovascular health before and during pregnancy across racial groups.
Main Methods:
- Utilized California birth hospitalization and vital statistics records (2007-2019).
- Examined hypertensive disorders of pregnancy, chronic hypertension, and gestational hypertension/preeclampsia.
- Assessed ideal cardiovascular health using clinical indicators and modified Poisson regression models.
Main Results:
- Adverse maternal cardiovascular outcomes worsened over time for all groups.
- Non-Hispanic Black mothers had a 60% higher risk of hypertensive disorders compared to White mothers.
- American Indian/Alaska Native mothers showed lower ideal cardiovascular health before and during pregnancy.
Conclusions:
- Significant racial and ethnic disparities exist in maternal cardiovascular health.
- These disparities persist and require urgent investigation.
- Structural determinants of these disparities need to be addressed.
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