Circulation. 2021 Oct 12;144(15):e251-e269. doi: 10.1161/CIR.0000000000001000. Epub 2021 Sep 8.
The United States has the highest maternal mortality rates among developed countries, and cardiovascular disease is the leading cause. Therefore, the American Heart Association has a unique role in advocating for efforts to improve maternal health and to enhance access to and delivery of care before, during, and after pregnancy. Several initiatives have shaped the time course of major milestones in advancing maternal and reproductive health equity in the United States. There have been significant strides in improving the timeliness of data reporting in maternal mortality surveillance and epidemiological programs in maternal and child health, yet more policy reforms are necessary. To make a sustainable and systemic impact on maternal health, further efforts are necessary at the societal, institutional, stakeholder, and regulatory levels to address the racial and ethnic disparities in maternal health, to effectively reduce inequities in care, and to mitigate maternal morbidity and mortality. In alignment with American Heart Association's mission "to be a relentless force for longer, healthier lives," this policy statement outlines the inequities that influence disparities in maternal outcomes and current policy approaches to improving maternal health and suggests additional potentially impactful actions to improve maternal outcomes and ultimately save mothers' lives.
美国是发达国家中孕产妇死亡率最高的国家,心血管疾病是主要原因。因此,美国心脏协会在倡导努力改善孕产妇健康以及在怀孕前、怀孕中和怀孕后增强获得和提供护理方面发挥着独特的作用。有几个举措影响了美国孕产妇和生殖健康公平方面的主要里程碑的时间进程。在改善孕产妇死亡率监测和母婴健康流行病学计划中的数据报告及时性方面已经取得了重大进展,但仍需要更多的政策改革。为了对孕产妇健康产生可持续和系统的影响,需要在社会、机构、利益攸关方和监管层面进一步努力,解决孕产妇健康方面的种族和族裔差异问题,有效减少护理方面的不平等,并减轻孕产妇发病率和死亡率。为了与美国心脏协会的使命“成为更长寿、更健康生活的不懈力量”保持一致,本政策声明概述了影响孕产妇结局差异的不平等现象以及目前改善孕产妇健康的政策方法,并提出了改善孕产妇结局、最终拯救母亲生命的其他潜在有影响力的行动。