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Every 2nd American woman has at least one risk factor for heart disease prior to pregnancy, study finds

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New research published today in the journal Circulation found that only around 40% of women in the United States who gave birth in 2019 had good heart health before their pregnancy, with excess weight being the leading cause of poor pre-pregnancy health, followed by hypertension and diabetes.

According to the AHA Heart Disease and Stroke Statistics 2022 Update, poor heart health puts both mothers-to-be and their children in danger, with heart disease accounting for more than one in four pregnancy-related deaths (26.5 percent).

The study team looked at data from the US Centers for Disease Control and Prevention’s Natality Database 2016-2019. They looked at 14,174,625 women who had live births and looked at their heart health risk factors before they became pregnant.

The women were 20-44 years old, with 81.4 percent being between the ages of 20 and 34. They were 52.7 percent non-Hispanic white, 22.7 percent Hispanic/Latina, and 14 percent non-Hispanic Black.

Having a normal body weight, with a BMI of 18-24.9 kg.m2 and no hypertension or diabetes, was considered as having optimal heart health.

They revealed:

  • Over the last three years, the overall percentage of women with good pre-pregnancy heart health has decreased by more than 3 percent, from 43.5 percent in 2016 to 40.2 percent in 2019.
  • In 2019, 37.1 percent of women aged 40-44 years old had good heart health, whereas 42.2 percent of women aged 30-34 years old had good heart health.
  • Before getting pregnant, more than one in every two women had at least one risk factor for cardiovascular disease, such as being overweight or obese, having high blood pressure, or having diabetes.
  • Before pregnancy, being overweight or obese was the most common cause of poor heart health.

The researchers then looked at data by geographic region, and found that while overall heart health was deteriorating across the country, there were regional disparities. States in the South (38.1 percent) and the Midwest (38.8 percent) had poorer heart health than states in the West (42.2 percent) and the Northeast (43.6 percent ). There were also differences between states, with fewer than a third (31.2 percent) of women in Mississippi having good heart health prior to pregnancy compared to almost half (47.2 percent) in Utah, the best performing state.

The researchers point out that social determinants of health, such as educational standing, Medicaid enrollment, access to preventative care, the ability to buy nutritious meals, and the characteristics of the women’s neighborhoods, appear to be the primary determinants of health.

“These geographic patterns are, unfortunately, very similar to what we see for heart disease and stroke in both men and women, and they indicate that social determinants of health play a critical role in maternal heart health as well,” highlights senior study author Sadiya S. Khan.

Source: 10.1161/CIRCULATIONAHA.121.057107

Image Credit: Getty

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