Of 155 million births in the United States between 1979 and 2018, more than 3,200 mothers died of high blood pressure-related causes— a 15-fold rise over the period. The risk was particularly high among Black women, according to the study.
“Women need good and timely initiation of prenatal care during pregnancy, but importantly, preconception care to diagnose and treat increased blood pressure prior to pregnancy is very important,” said lead author Cande Ananth, chief of epidemiology and biostatistics at Rutgers Robert Wood Johnson Medical School in New Brunswick, N.J.
While maternal death rates due to high blood pressure during pregnancy (preeclampsia) fell in the United States over the last four decades, death rates from chronic high blood pressure substantially increased — on average, by about 9% a year, according to the study.
“There is also a disconcerting race disparity in these unfavorable trends…, with Black women at substantially and disproportionately increased risk than white women,” he said. “The study underscores the need for focusing improvements in such areas as advanced maternal age, obesity and racial inequities in access to care.”
About a third of maternal deaths occur before delivery; a third on the day of delivery or within a week; and a third one week to a year after delivery, according to the study.
They estimated that 75% of the maternal deaths were preventable.
Notably, those linked to high blood pressure increased with age and were highest among women between 45 and 49. Deaths also increased with obesity.
Among Black women, the risk was even higher.
Compared with white women, they had three to four times the risk of dying from blood pressure-related causes, the study found. And, Ananth said, that racial disparity has persisted for 40 years.
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