Disparities in Cardiovascular Disease Outcomes Among Pregnant and Post-Partum Women.
J Am Heart Assoc
; 10(1): e017832, 2021 01 05.
Article
em En
| MEDLINE
| ID: mdl-33322915
ABSTRACT
Background The incidence of cardiovascular disease among pregnant women is rising in the United States. Data on racial disparities for the major cardiovascular events during pregnancy are limited. Methods and Results Pregnant and post-partum women hospitalized from January 2007 to December 2017 were identified from the Nationwide Inpatient Sample. The outcomes of interest included in-hospital mortality, myocardial infarction, stroke, pulmonary embolism, and peripartum cardiomyopathy. Multivariate regression analysis was used to assess the independent association between race and in-hospital outcomes. Among 46 700 637 pregnancy-related hospitalizations, 21 663 575 (46.4%) were White, 6 302 089 (13.5%) were Black, and 8 914 065 (19.1%) were Hispanic. The trends of mortality and stroke declined significantly in Black women, but however, were mostly unchanged among White women. The incidence of mortality and cardiovascular morbidity was highest among Black women followed by White women, then Hispanic women. The majority of Blacks (62.3%) were insured by Medicaid while the majority of White patients had private insurance (61.9%). Most of Black women were below-median income (71.2%) while over half of the White patients were above the median income (52.7%). Compared with White women, Black women had the highest mortality with adjusted odds ratio (aOR) of 1.45, 95% CI (1.21-1.73); myocardial infarction with aOR of 1.23, 95% CI (1.06-1.42); stroke with aOR of 1.57, 95% CI (1.41-1.74); pulmonary embolism with aOR of 1.42, 95% CI (1.30-1.56); and peripartum cardiomyopathy with aOR of 1.71, 95 % CI (1.66-1.76). Conclusions Significant racial disparities exist in major cardiovascular events among pregnant and post-partum women. Further efforts are needed to minimize these differences.
Palavras-chave
Texto completo:
1
Temas:
ECOS
/
Aspectos_gerais
/
Equidade_desigualdade
/
Estado_mercado_regulacao
Bases de dados:
MEDLINE
Assunto principal:
Complicações Cardiovasculares na Gravidez
/
Transtornos Puerperais
/
Doenças Cardiovasculares
/
Mortalidade Hospitalar
/
Disparidades nos Níveis de Saúde
/
Disparidades em Assistência à Saúde
Tipo de estudo:
Incidence_studies
/
Prognostic_studies
/
Risk_factors_studies
Aspecto:
Determinantes_sociais_saude
/
Equity_inequality
/
Patient_preference
Limite:
Adult
/
Female
/
Humans
/
Pregnancy
País/Região como assunto:
America do norte
Idioma:
En
Revista:
J Am Heart Assoc
Ano de publicação:
2021
Tipo de documento:
Article