Maternal deaths (ie, during pregnancy or <42 days after delivery) have increased in the US in recent years, with 1205 maternal deaths reported in 2021. The resultant maternal mortality rate of 32.9 deaths per 100 000 live births is a significant increase from 20.1 in 2019.1 Additionally, significant disparities exist in maternal mortality, with 2- to 3-fold higher rates among American Indian/Alaska Native and non-Hispanic Black people compared with non-Hispanic White individuals. Approximately 80% of these deaths are preventable, with more than half occurring after delivery, which underscores the postpartum period as a critical time to monitor maternal health. Although the causes of maternal mortality are multifactorial, cardiovascular diseases (CVDs) are a major contributor. The prevalence of poor cardiovascular health (CVH) among individuals prior to pregnancy has increased significantly with less than half of individuals entering pregnancy with favorable CVH.2 Further, adverse pregnancy outcomes (APOs; hypertensive disorders of pregnancy, gestational diabetes, preterm birth, and small-for-gestational age birth) complicate more than 1 in 5 live births in the US, are markers of poor CVH, and are associated with higher lifetime risk of CVD. The first year postpartum provides an opportunity for clinicians to measure, modify, and monitor CVH. Specific recommendations are listed in the Table.
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CME Disclosure Statement: Unless noted, all individuals in control of content reported no relevant financial relationships. If applicable, all relevant financial relationships have been mitigated.
Corresponding Author: Sadiya S. Khan, MD, MSc, Northwestern University Feinberg School of Medicine, 680 N Lakeshore Dr, Ste 1400, Chicago, IL 60611 (email@example.com).
Published Online: November 15, 2023. doi:10.1001/jama.2023.19192
Conflict of Interest Disclosures: Dr Khan reported grants from the National Institutes of Health (R01HL161514) during the conduct of the study and outside the submitted work (HL159250 and U01HL160279). No others were reported.
Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:
It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.
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