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The Influence of Personal and Family Support on Maternal Cardiovascular Health: Insights from a TriNetX Study
Oluwaremilekun Zeth Tolu-Akinnawo1, Anderson Anuforo2, Ikeoluwapo Kendra Bolakale-Rufai3
1Meharry Medical College, Nashville, Tennessee, USA.
Background:
Maternal cardiovascular health during and after pregnancy is shaped by biological, behavioral, and social factors. Inadequate personal and family support remains underexplored as a driver of postpartum cardiovascular risk. Understanding this relationship is vital for developing targeted interventions.
Methods:
Using the TriNetX U.S. Collaborative Network, we examined postpartum cardiovascular outcomes among women aged 15-60 years with documented problems in personal or family support (poor support cohort, Cohort 1) compared with matched controls (Cohort 2) with no support-related Z63 codes. Personal/family support concerns were defined using ICD-10 Z63.x codes recorded 9 months before to 1 year after delivery or postpartum encounters. Propensity score matching was applied. Outcomes were assessed within 1 year.
Results:
After matching (n = 10,669 per cohort), inadequate support was associated with higher odds of major adverse cardiac and cerebrovascular events (odd ratio [OR] 5.012, 95% CI: 3.461-7.257) and acute kidney injury (OR: 1.438, 95% CI: 1.015-2.039). No significant differences were observed for myocardial infarction, stroke, heart failure, or peripartum cardiomyopathy.
Conclusion:
Poor personal and family support is associated with adverse maternal cardiovascular outcomes. Caution is warranted in interpreting mortality due to potential misclassification. Integrating psychosocial support into postpartum care may reduce risk and improve maternal outcomes.
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