New study emphasizes the importance of cardiovascular health in postpartum care

Continuing regular check-ups for some mothers into the “fourth-trimester” — the three month after giving birth —may help reduce cardiovascular-related deaths, a top indirect cause of maternal deaths, according to the American Heart Association.

Patients who have diabetes or high blood pressure during pregnancy are more likely to develop cardiovascular disease even after giving birth. And despite 64% having some type of postpartum appointment, patients with these certain risk factors were not usually assessed for changes related to their conditions in follow-up appointments, according to the study published Nov. 27 in Circulation: Cardiovascular Quality and Outcomes. 

Only about 29% of mothers with diabetes were given glucose screening at a follow-up appointment. Of those who had their levels checked postpartum, 25% reported elevated levels. Some were prescribed medication for the elevated levels, and others were referred to a cardiologist. 

Meanwhile, 90% of mothers with hypertension had their blood pressure evaluated at a follow-up appointment and around 33% of them had elevated blood pressure levels, according to the study. Of that group, 8% were referred to a cardiologist and around 50% were given medication to manage the condition.

Outcomes were also worse for women who reported being on Medicaid or who are Black or American Indian. 

“Providers and health care leaders need to identify the barriers to completing postpartum visits and work with women and their families to improve access to care,” Courtney Jordan Baechler, MD, a cardiologist and medical director for Health Equity and Health Promotion at the Minneapolis Heart Institute Foundation stated. “The goal is to support women, many of whom are balancing young children, careers, suboptimal insurance coverage, health care distrust, lack of transportation and other known social barriers of heart health and care access.”

Improvement in maternal health outcomes and access to care is a national goal as part of the HHS’s Healthy People 2023 initiative.