Risk Of Maternal Mortality Research Articles

Difference in Time to Delivery Between Dilation and Evacuation (D&E) Versus Induction of Labor for Medical Indications [ID: 1380391

INTRODUCTION: Pregnancy termination may be the safest management option among pregnancies with medical conditions that arise during the second trimester and are associated with elevated risk of maternal morbidity and mortality. Termination can be done by dilation and evacuation (D&E) or induction. Each method carries different risk and benefit profiles; however, variations in time to delivery have not been established. We assess the difference in time from diagnosis to delivery between D&E and induction for medically indicated second-trimester terminations. METHODS: Electronic medical records of 85 adult patients who underwent a D&E and 19 who underwent an induction between July 1, 2020, and December 31, 2020, within Kaiser Permanente Northern California were retrospectively surveyed for patient demographics and clinical characteristics, including indication for and method of termination, time of diagnosis and delivery, cervical preparation method, and perioperative complications. RESULTS: Patient demographic and clinical characteristics were similar across groups. The median time from diagnosis to delivery was 74 hours (interquartile range [IQR]: 18–141 hours) in the D&E cohort and 9 hours (IQR: 4–45 hours) in the induction cohort (P<.01). In the induction cohort, there were 21.1% (n=4) complications versus 4.7% (n=4) in the D&E cohort (P=.04). In the induction group, 10.5% (n=2) of patients required an additional procedure to complete the termination. CONCLUSION: The median time from diagnosis to delivery was 65 hours shorter in the induction group compared to D&E. This difference may be deemed clinically significant for patients who weigh time to delivery in their decision-making.

Prevalence and impact of SARS-CoV-2 infection on maternal and infant health in African populations: protocol of a multicentre prospective cohort study (MA-CoV project)

IntroductionPregnant women are currently considered a vulnerable population to SARS-CoV-2 infection, with increased risk of severe COVID-19, preterm birth and maternal mortality. There is, however, a paucity of data on...

Factors that influence the uptake of postnatal care among adolescent girls: a qualitative evidence synthesis

BackgroundAdolescent pregnancy is associated with increased risk of maternal and child morbidity and mortality globally. Access to safe, appropriate and affordable antenatal, childbirth and postnatal care (PNC) is essential in...

Perceptions of adolescent mothers towards adolescent repeat childbirth in Soroti district, Teso sub-region, Uganda: A phenomenological study.

The percentage of adolescent mothers aged 15 to 19 years with a repeat childbirth in Uganda (26.1%) is higher than the global estimate (18.5%). Soroti district tops Teso (a region with highest adolescent childbearing rate nationally) in adolescent childbearing. Adolescent repeat childbearing (ARC) is associated with poor health outcomes, increased risk of stillbirth, maternal and child mortality, thus a public health concern. The explanations to the high prevalence of repeat childbirth in Soroti district remain unknown. We conducted a phenomenological study where theoretical saturation was achieved with 3 focus group discussions; each comprised of 8 respondents. The questions posed focused on modified socio-ecological model regarding the factors associated with repeat childbirth. These included; perceived individual factors of repeat childbirth, factors related to the sexual partner of the adolescent mother, adolescent mother's family related factors and factors related to the peers and community of the adolescent mothers. Transcripts were organized and analyzed by QSR Nvivo following deductive approach. Results: Adolescent marriage was viewed as a privilege, family planning methods were viewed as non-functional, man's demand for sex was unchallengeable and non-supportive families including mistreatment of the participants by their families were perceived as risk factors for ARC. This therefore suggests that in order to prevent repeat adolescent childbearing in Soroti district, and contribute towards the achievement of the SDG numbered three (ensure healthy lives and promote well-being for all at all ages) there is need to awaken and strengthen the implementation of the anti-teen marriage programs and policies; strengthen sexual/reproductive education including family planning programs, and addressing identified myths regarding ARC.

Challenges in last mile distribution of family planning commodities: Effects on product availability and accessibility in Nigeria.

Family planning (FP) reduces maternal and child mortality risk. Despite policies and plans to improve FP in Nigeria, access remains poor leading to high unmet need. Contraceptive use is still as low as 4.9% in some regions. Thus, this study assessed challenges in FP commodities distribution and its effect on accessibility. Descriptive survey was used to explore last mile distribution of FP commodities in 287 facilities across various levels of FP service provision. Also, 2528 end users of FP services were assessed to ascertain their attitudes towards FP services. Data were analysed using IBM Statistical Package for the Social Sciences version 25. Only 16% of the facilities had all the basic infrastructure requirements assessed with majority of the facilities having inadequate human resource capacity on logistics and supply chain management of health commodities. The study also identified positive attitudes towards FP (80%) and low incidence of stigmatising attitudes (5.4%). The study identified challenges in distribution of FP commodities including frequent stock out of commodities and socio-cultural barriers. Increased positive attitude and limited stigmatising attitudes provides policy directions that are relevant for decision makers to align FP policies and strategies to improve last mile distribution of FP commodities.

Googling preterm prelabour rupture of the membranes: A systematic review of patient information available on the internet.

Preterm prelabour rupture of the membranes (PPROM) complicates 3% of pregnancies and is associated with an increased risk of maternal and perinatal morbidity and mortality. In an attempt to better understand this diagnosis, patients routinely resort to the internet for medical information. The lack of governance online leaves patients at risk of relying on low-quality websites. To assess systematically the accuracy, quality, readability and credibility of World Wide Web pages on PPROM. Five search engines (Google, AOL, Yahoo, Ask and Bing) were searched with location services and browser history disabled. Websites from the first page of all searches were included. Websites were included if they provided at least 300 words of health information aimed at patients relating to PPROM. Validated assessments of health information readability, credibility and quality were undertaken, as was an accuracy assessment. Pertinent facts for accuracy assessment were based on feedback from healthcare professionals and patients through a survey. Characteristics were tabulated. In all, 39 websites were included, with 31 different texts. No pages were written with a reading age of 11 years or less, none were considered credible, and only three were high quality. An accuracy score of 50% or more was obtained by 45% of websites. Information that patients considered pertinent was not consistently reported. Search engines produce information on PPROM that is low quality, low accuracy and not credible. It is also difficult to read. This risks disempowerment. Healthcare professionals and researchers must consider how to ensure patients have access to information that they can recognise as high quality.

Laparoscopic treatment of advanced interstitial pregnancy: key steps for a successful management

To describe a conservative laparoscopic treatment of an advanced case of interstitial pregnancy diagnosed in a woman at 14 weeks of gestational age. Video case report with demonstration of diagnostic work-up and laparoscopic management of rare subtypes of ectopic pregnancy SETTING: University tertiary care hospital. A 32-year-old nulliparous woman at 14 weeks of gestational age, presented with moderate abdominal pain. She reported an history of irregular periods however, no risk factor for ectopic pregnancy were identified. HCG levels was 7345 mIU/mL. Transvaginal ultrasound revealed an empty uterine cavity and a complex heterogeneous mass of 6 cm on the left cornual region. Myometrial thickness surrounding the gestational sac was 4 mm. There were several critical strategies for this laparoscopic approach. To reduce intraoperative bleeding, the peritoneum was opened, the ureters were identified, and bulldog clamps were used to temporarily reduce uterine vascularization. An intramyometrial injection of vasopressin was performed. After a first cornuostomy attempt, we had to get on a cornual resection to achieve a complete removal of the ectopic mass. Multilayer uterine suture and anatomical restoration to prevent adhesion was then accomplished. Institutional review board approval was not required for this case report as per our institution's policy; patient consent was obtained for publication of the case. Description of a laparoscopic management of huge interstitial pregnancy RESULTS: The overall operation time was 55 minutes, and the estimated blood loss was 55cl. A successfully conservative treatment was achieved with no short-term complications. Postoperative ultrasound showed a normal uterus and complete regression of hCG was obtained two weeks after surgery. Interstitial ectopic pregnancy presents a high risk of maternal mortality considering that the interstitial part of the tube, because of its thickness, has a great capacity to expand before rupture.

The role of the pregnancy heart team in clinical practice.

Significant maternal and fetal morbidity and mortality risk has been shown to be associated with cardiovascular disease in pregnancy. Several determinants, such as the increasing number of females with corrected congenital heart disease in reproductive age, a more advanced maternal age associated with cardiovascular risk factors, and a greater prevalence of preexisting comorbidities related to cardiac disorders such as cancer and COVID-19), lead to a higher incidence of cardiac complications in pregnancy in the last few decades. However, adopting a multidisciplinary strategy may influence maternal and neonatal outcomes. This review aims at assessing the role of the Pregnancy Heart Team, which should ensure careful pre-pregnancy counseling, pregnancy monitoring, and delivery planning for both congenital and other cardiac or metabolic disorders, addressing several emerging aspects in the multidisciplinary team-based approach.

Prevalence and risk factors for prenatal parasitic infections and anaemia among pregnant women in Kaduna State, Nigeria

In developing nations, anaemia is one of the most prevalent medical conditions. It has long been known that parasite infection during pregnancy is one of the main causes of anaemia and an elevated risk of maternal mortality. To ascertain the prevalence and risk factors related to parasite infections and anaemia among pregnant women receiving prenatal care in some selected public health facilities in Kaduna State, Nigeria, an eleven-month cross- sectional study of 180 consenting pregnant women was conducted from February to December 2017. A standardized questionnaire was used to interview the sampled pregnant women. Stool and blood samples of each consented pregnant woman were collected. Formal-ether sedimentation technique, thin and thick blood smears and haematocrit packed cell volume capillary methods were used to screen intestinal helminth parasites, plasmodium species and Packed Cell Volume (PCV) respectively. The result obtained showed parasitic infections prevalence of 102(56.7%) among the study population. Prevalence of Plasmodium species, hookworm, Ascaris lumbricoides and those with co-infection all occurred at 47.2%, 16.7%, 17.8% and 25.0% respectively. Age, educational level, trimester and parity were all significant predictors of Plasmodium species prevalence (p<0.005). Similarly, parity and educational level were significantly (p<0.005) associated with the prevalence of intestinal parasites and co-infection. Anaemia was present in 40.0% of the examined pregnant women. Trimester and educational level were highly significant (p<0.001) predictors of anaemia among the sampled pregnant women. Plasmodium species were the most common parasitic species associated with anaemia as 43.1% of Plasmodium species-infected pregnant women had anaemia compared to those with intestinal helminth infection (30.6%) and co-infection (13.3%). However, statistical analysis revealed a significant association (p<0.05) between the prevalence of anaemia and intestinal helminth infection. Therefore, measures such as improved sanitation and health education are needed to lessen the prevalence of parasitic infections and parasite-related anaemia in the study area.

Anemia in pregnancy: A case control study from India

According to the World Health Organization (WHO) in pregnancy hemoglobin (Hb) less than 11gm/dL refers to be anemia. Anemia is the most common nutritional deficiency affecting the pregnant women. In India prevalence of anemia in pregnant woman is about 65% to 75%. Anemia during pregnancy causes negative and harmful effects on mother as well as on child. Anemia increases the risk of maternal and perinatal mortality. India had the highest prevalence of anemia in pregnancy. The Highest number of anemic pregnant women in the world are in India. So the present study was planned with aim to study the anemia in pregnant women. The present case-control study was carried out in Department of Physiology at Rural Medical College Loni in Ahmednagar district of Maharashtra. The study was approved by Institutional Ethical Committee. Total 644 subjects were recruited for the study. 161 non-pregnant women were taken as control and 483 pregnant women were taken as the cases. Hemoglobin measurements of the pregnant woman was done by Sahali’s method. Hb concentration of <11 gm/dL taken as anemia. The prevalence of anemia in pregnant and non-pregnant women were 62.93% and 82.60% respectively. Pregnant as well as non-pregnant women in India are at high risk of developing anemia. The various national programmes aimed at prevention of anemia reduced the prevalence as well as severity of anemia during pregnancy.

Reduction in CgA-Derived CST Protein Level in HTR-8/SVneo and BeWo Trophoblastic Cell Lines Caused by the Preeclamptic Environment.

One of the most dangerous complications of pregnancy is preeclampsia (PE), a disease associated with a high risk of maternal and fetal mortality and morbidity. Although its etiology remains unknown, the placenta is believed to be at the center of ongoing changes. One of the hormones produced by the placenta is chromogranin A (CgA). Thus far, its role in pregnancy and pregnancy-related disorders is enigmatic, yet it is known that both CgA and its derived peptide catestatin (CST) are involved in the majority of the processes that are disturbed in PE, such as blood pressure regulation or apoptosis. Therefore, in this study, the influence of the preeclamptic environment on the production of CgA using two cell lines, HTR-8/SVneo and BeWo, was investigated. Furthermore, the capacity of trophoblastic cells to secrete CST to the environment was tested, as well as the correlation between CST and apoptosis. This study provided the first evidence that CgA and CST proteins are produced by trophoblastic cell lines and that the PE environment has an impact on CST protein production. Furthermore, a strong negative correlation between CST protein level and apoptosis induction was found. Hence, both CgA and its derived peptide CST may play roles in the complex process of PE pathogenesis.

Comorbidities associated with maternal mortality from COVID-19 in Mexico.

In Mexico, there is a syndemic in pregnant women, where the epidemic of obesity and chronic diseases coexists with that of coronavirus disease 2019 (COVID-19), which has been associated with a higher risk of maternal mortality. To evaluate the association of comorbidities during pregnancy with maternal mortality from COVID-19 in Mexico. SISVER COVID-19 databases and epidemiological surveillance reports on maternal mortality were used. Multivariate logistic regression models were used to evaluate the association of comorbidities with maternal deaths from COVID-19. A total of 29,416 pregnant women were evaluated, out of which 39% were positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2); the risk of maternal mortality was 3.24 times higher (p < 0.01) for positive in comparison with negative women. COVID-19 is the leading cause of maternal death since July 2020 and explains more than 50% of total deaths in 2021. Chronic kidney disease (odds ratio [OR]: 4.11; p < 0.01) and diabetes (OR: 2.53; p < 0.01) were the two main comorbidities that were positively associated with maternal death from COVID-19. Comorbidities during pregnancy that are possibly associated with an increase in the inflammatory response and an alteration of the immune response increase the risk of maternal death from COVID-19 in Mexican pregnant women.

Understanding clinical outcome measures reported in HIV pregnancy studies involving antiretroviral-naive and antiretroviral-experienced women.

HIV infection is a clinically significant public health disease and contributes to increased risk of maternal and fetal morbidity and mortality. HIV pregnancy studies use outcome measures as metrics to show how people with HIV feel, function, or survive. These endpoints are crucial for tracking the evolution of HIV illness over time, assessing the effectiveness of antiretroviral therapy (ART), and comparing outcomes across studies. Although the need for ideal outcome measures is widely acknowledged, selecting acceptable outcome measures for these HIV pregnancy studies can be challenging. We discuss the many outcome measures that have been implemented over time to assess HIV in pregnancy studies, their benefits, and drawbacks. Finally, we offer suggestions for improving the reporting of outcome measures in HIV in pregnancy studies. Medical professionals can best care for pregnant women living with HIV receiving ART by having a thorough understanding of these outcome metrics.

Black-White disparities in maternal vulnerability and adverse pregnancy outcomes: an ecological population study in the United States, 2014–2018

Systematic information on the association between community-level determinants and maternal health outcomes and disparities is needed. We aimed to investigate multi-dimensional place-based contributions to Black-White maternal health disparities in the United States. We constructed the Maternal Vulnerability Index, a geospatial measure of vulnerability to poor maternal health. The index was linked to 13m live births and maternal deaths to mothers aged 10-44 for 2014-2018 in the United States. We quantified racial disparities in exposure to higher risk environments, and used logistic regression to estimate associations between race, vulnerability, and maternal death (n=3633), low birthweight (n=1.1m), and preterm birth (n=1.3m). Black mothers lived in disproportionately higher maternal vulnerability counties, when compared to White mothers (median of 55 vs 36/100 points). Giving birth in the highest-quartile MVI counties was associated with an increase in the odds of poor outcomes when compared to the lowest-quartile (aOR 1.43 [95% CI 1.20-1.71] for mortality, 1.39 [1.37-1.41] for low birthweight and 1.41 [1.39-1.43] for preterm birth, adjusted for age, educational attainment level and race/ethnicity). Racial disparities exist in low- and high-vulnerability counties: Black mothers in the least vulnerable counties remain at higher risk of maternal mortality, preterm birth, and low birthweight as White mothers in the most vulnerable. Exposure to community maternal vulnerability is associated with increased odds of adverse outcomes, but the Black-White gap in outcomes remained under all vulnerability levels. Our findings suggest that locally-informed precision health interventions and further research into racism are needed to achieve maternal health equity. Bill & Melinda Gates Foundation(grant number INV-024583).

Management of unexpected placenta accreta spectrum cases in resource-poor settings

On a global scale, cases of placenta accreta spectrum are often just identified during cesarean delivery because they are missed during antenatal care screening. Routine operating teams not trained in the management of placenta accreta spectrum are faced with difficult surgical situations and have to make decisions that may define the clinical outcomes. Although there are general recommendations for the intraoperative management of placenta accreta spectrum, no studies have described the clinical reality of unexpected placenta accreta spectrum cases in resource-poor settings. This study aimed to describe the maternal outcomes of previously undiagnosed placenta accreta spectrum managed in resource-poor settings in Colombia and Indonesia. This was a retrospective case series of women with histologically confirmed placenta accreta spectrum treated in 2 placenta accreta spectrum centers after referral from remote resource-poor hospitals. Clinical outcomes were analyzed according to the initial type of management: (1) no cesarean delivery; (2) placenta left in situ after cesarean delivery; (3) partial removal of the placenta after cesarean delivery; and (4) post-cesarean hysterectomy. In addition, we evaluated the use of telemedicine by comparing the outcomes of women in hospitals that used the support of the placenta accreta spectrum center during the initial surgery. A total of 29 women who were initially managed in Colombia (n=2) and Indonesia (n=27) were included. The lowest volume of blood loss and the lowest frequency of complications were in women who underwent deferred cesarean delivery (n=5; 17.2%) and in those who had a delayed placental delivery (n=5; 20.7%). Five maternal deaths (14%) occurred in the group that did not receive telehelp, and 4 women died of irreversible shock because of uncontrolled bleeding. Previously undiagnosed placenta accreta spectrum in resource-poor hospitals was associated with a high risk of maternal mortality. Open-close abdominal surgery or leaving the placenta in situ seem to be the best choices for unexpected placenta accreta spectrum management in resource-poor settings. Telemedicine with a placenta accreta spectrum center may improve prognosis.

Efforts to Prevent Child Age Marriage in The Study of Islamic Legal Philosophy and Indonesia Positive Law

Children are the next generation of the nation who are expected to become ideal human beings, tough, superior, competitive and responsive to changing times, as well as being able to become a driving force for community and nation development to break down weakness, poverty and underdevelopment. The quality of Indonesian children greatly determines the existence and ability of the Indonesian nation to compete with other countries. This study uses the library research method (normative law) with an approach to law and philosophy of Islamic law. The data analyzed are legal rules contained in Islamic law and positive law. The research concluded that the fulfillment of children's rights is highly dependent on the government, society, the business world, and the media being present to be able to provide comprehensive protection. However, this will not be achieved because child marriage in Indonesia is still quite high. In global discourse, child marriage is considered a tradition that harms and protects human rights. The main negative consequences for girls are reduced risks of educational opportunities, reproductive health and increased risks of maternal and child mortality. Child marriage is also a source of psychological trauma and domestic and sexual violence. The results of this study indicate that the government has made efforts to reduce the number of child marriages with various regulations and policies, although they are considered not optimal, partly because there are no sanctions for perpetrators of child marriage. But there are still many who argue because in Islamic family law it is permissible to marry after puberty. Therefore, this article argues that form perspective of the philosophy of Islamic law, child marriage causes more harm, therefore prevention efforts must be supported by various elements, goverments, family, legal actor and society.

Long term renal outcome after hypertensive disease during pregnancy: a nationwide population-based study.

Hypertensive disease during pregnancy increases the risk of maternal morbidity and mortality and leads to the development of multi-organ dysfunction, including kidney dysfunction. Complicated pregnancies require careful postpartum management to prevent sequelae. It is believed that kidney injury can consistently occur even after delivery; therefore, defining the chronicity and endpoint is essential for establishing diagnostic criteria. However, data on the prevalence of persistent renal complications following hypertensive disease during pregnancy are limited. In this study, we evaluated the risk of developing renal disorders in patients with a history of hypertensive disease during pregnancy. Participants who gave birth between 2009 and 2010 were followed up for 8 years after delivery. The risk of renal disorder development after delivery was compared according to a history of hypertensive disease during pregnancy. Different factors that could affect the course of pregnancy, including age, primiparity, multiple pregnancy, preexisting hypertension, pregestational diabetes, hypertensive disease during pregnancy, gestational diabetes, postpartum hemorrhage, and cesarean section, were adjusted for using the Cox hazard model. Women with hypertension during pregnancy had a higher risk of developing renal disorders after delivery (0.23% vs. 1.38%; P<0.001). This increased risk remained significant even after adjusting for covariates (adjusted hazard ratio, 3.861; 95% confidence interval [CI], 3.400-4.385] and 4.209 [95% CI, 3.643-4.864], respectively). Hypertension during pregnancy can contribute to the development of renal disorders, even after delivery.

Interventions to improve enablers and/or overcome barriers to seeking care during pregnancy, birthing and postnatal period for women living with vulnerabilities in high-income countries: A systematic review and meta-analysis

ObjectiveTo reduce maternal morbidity and mortality, World Health Organization recommendations include: commencing pregnancy care before 12-weeks’, at least eight antenatal and four postnatal visits, and attendance of skilled care at birthing. While lower adherence to the recommendation predominates in low- and middle-income countries, it also occurs in some settings in high-income countries. Globally, various strategies are used to optimise maternity care, in line with these recommendations. This systemic review aimed to determine if enhanced care improves maternal care-seeking, thus improving clinical outcomes for women and babies living with vulnerabilities, in high-income countries. Design, setting and participantsWe searched the Cochrane Central Registers of Controlled Trials and Cochrane Pregnancy and Childbirth, MEDLINE, CINAHL, Proquest Dissertation and Thesis and reference lists of relevant articles. The latest search was performed June 20, 2022. Randomised controlled trials, non-randomised intervention trials and cohort studies comparing effects of interventions designed to increase utilisation of maternal health services with routine care, for women at increased risk of maternal mortality and severe maternal morbidity in high-income countries were included. Two authors selected, extracted, assessed and analysed data. Additional information was sought from study authors. This systematic review and meta-analysis was registered with PROSPERO(CRD42021256811). FindingsNine studies with 5,729 participants were included. Interventions to enhance care significantly increased utilisation of health services, increasing attendance at antenatal classes (Odds Ratio[OR]=15·23, 95%Confidence Interval[CI] 10·73–21·61, p<0·0001) and postnatal visits by 6–8 weeks (OR=2·66, 95%CI 1·94–3·64, p<0·0001), compared to routine care. Infants in the intervention groups were significantly less likely to be: born preterm (OR=0·68, 95%CI 0·56–0·82, p<0·0001); low birthweight (OR=0·78, 95%CI 0·64–0·95, p = 0·01) or; require neonatal intensive care (OR=0·80, 95%CI 0·66–0·96, p = 0·02). Conclusions and Implications for practiceAmong women living with vulnerabilities in high-income countries, interventions to enhance care increases utilisation of maternal health services and improves outcomes.

Effect of Nutritional Status and Anemia in the Wound Healing Process of Post Cesarean Section Patients

Sectio Caesarea is an action to deliver a baby weighing more than 500 grams, through an incision in the intact uterine wall. The increase in cesarean section rates has not been able to improve the final condition of the neonate and can even increase the risk of maternal mortality and morbidity. The purpose of this study was to determine the Relationship between Anemia and Nutritional Status with the Wound Healing Process in Postoperative Sectio Caesarea Patients in the Hospital Postpartum Room. This study was conducted based on analytical research methods using a cross-sectional approach. the results of the Chi-square test analysis obtained a value of ρ value = 0.001 (ρ &lt; 0.05), where Ha is accepted and H0 is rejected, so there is a significant relationship between Anemia and the Wound healing Process in Postoperative Sectio Caesarea patients in the Hospital Postpartum Room.

Chronic Hypertension in Pregnancy: A Lens Into Cardiovascular Disease Risk and Prevention.

Hypertension is a major, modifiable risk factor for cardiovascular disease (CVD) in the United States. Over the past decade, the prevalence of chronic hypertension (CHTN) during pregnancy has nearly doubled with persistent race- and place-based disparities. Blood pressure elevations are of particular concern during pregnancy given higher risk of maternal and fetal morbidity and mortality, as well as higher lifetime risk of CVD in birthing individuals with CHTN. When identified during pregnancy, CHTN can, therefore, serve as a lens into CVD risk, as well as a modifiable target to mitigate cardiovascular risk throughout the life course. Health services and public health interventions that equitably promote cardiovascular health during the peripartum period could have an important impact on preventing CHTN and reducing lifetime risk of CVD. This review will summarize the epidemiology and guidelines for the diagnosis and management of CHTN in pregnancy; describe the current evidence for associations between CHTN, adverse pregnancy outcomes, and CVD; and identify opportunities for peripartum care to equitably reduce hypertension and CVD risk throughout the life course.