Differential Outcomes for African-American Women with Cardiovascular Complications of Pregnancy

Abstract

Maternal mortality is rising in the USA, and cardiovascular disease is the leading cause of death. Black women are 3 times more likely to die than White women as a result of pregnancy-related causes. In this review, we describe the differential outcomes of Black women with cardiovascular conditions related to pregnancy. Black women have a higher risk of developing peripartum cardiomyopathy (PPCM) and preeclampsia compared to White women. Black women with PPCM present with more severe disease and are less likely to experience myocardial recovery. Black women with preeclampsia are at higher risk of severe maternal morbidity and mortality compared to White women, regardless of socioeconomic status. The higher prevalence of chronic medical conditions among Black women do not fully explain the higher rates of adverse outcomes. Racial differences in outcomes for other cardiovascular conditions have not been well-described. Black women are at significantly higher risk of cardiovascular complications related to pregnancy. Interventions focused on access to care, quality of care, and social determinants of health before, during, and after pregnancy may improve maternal outcomes, especially for Black women in the USA.