Briller Joan, Trost Susanna L, Busacker Ashley, Joseph Naima T, Davis Nicole L, Petersen Emily E, Goodman David A, Hollier Lisa M
Division of Cardiology, Department of Medicine, University of Illinois Chicago, Chicago, Illinois, USA.
Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
JACC Adv. 2024 Nov 8;3(12):101382. doi: 10.1016/j.jacadv.2024.101382. eCollection 2024 Dec.
Cardiomyopathy (CM) and other cardiovascular conditions (OCVs) are among the most frequent causes of pregnancy-related death in the United States.
The purpose of this paper was to report demographic and clinical characteristics, preventability, contributing factors, and Maternal Mortality Review Committee (MMRC) recommendations among pregnancy-related deaths with underlying causes of CM, OCVs, and the 2 combined (cardiovascular conditions, CV).
We analyzed pregnancy-related death data from MMRCs in 32 states, occurring during 2017 to 2019, with MMRC-determined underlying causes of CVs. We describe distributions of demographic characteristics, present the most frequent contributing factor classes, and provide example MMRC prevention recommendations.
Among 210 pregnancy-related deaths due to CVs, 84 (40%) were due to CM and 126 (60%) to OCVs. More than half (51.2%) of CM deaths were among non-Hispanic Black persons. Two-thirds (66%) of all CV deaths occurred among people <35 years old. Approximately 53% of CM deaths and 31% of OCV deaths occurred 43 to 365 days postpartum. Over 75% of pregnancy-related deaths due to CVs were determined by MMRCs to be preventable. The 5 most frequent contributing factor classes accounted for 50% of the total MMRC-identified contributing factors. MMRC prevention recommendations occur at multiple levels.
Most pregnancy-related deaths due to CM and OCV are preventable. Example MMRC recommendations provided in this report illustrate prevention opportunities that address contributing factors, including broader awareness of urgent warning signs, improved handoffs for care coordination and continuity, and expanded accessibility of community-based comprehensive and integrated care services.
在美国，心肌病（CM）和其他心血管疾病（OCV）是与妊娠相关死亡的最常见原因之一。
本文旨在报告与妊娠相关死亡的人口统计学和临床特征、可预防性、促成因素，以及孕产妇死亡审查委员会（MMRC）针对潜在病因是CM、OCV以及两者合并（心血管疾病，CV）的妊娠相关死亡所提出的建议。
我们分析了2017年至2019年期间32个州MMRC的与妊娠相关死亡数据，这些死亡由MMRC确定的CV潜在病因导致。我们描述了人口统计学特征的分布，列出最常见的促成因素类别，并提供MMRC预防建议的示例。
在210例因CV导致的与妊娠相关死亡中，84例（40%）是由CM导致，126例（60%）是由OCV导致。超过一半（51.2%）的CM死亡发生在非西班牙裔黑人中。所有CV死亡的三分之二（66%）发生在35岁以下人群中。约53%的CM死亡和31%的OCV死亡发生在产后43至365天。MMRC确定超过75%的因CV导致的与妊娠相关死亡是可预防的。5个最常见的促成因素类别占MMRC确定的促成因素总数的50%。MMRC的预防建议涵盖多个层面。
大多数由CM和OCV导致的与妊娠相关死亡是可预防的。本报告中提供的MMRC建议示例说明了针对促成因素的预防机会，包括提高对紧急警示信号的广泛认识、改善护理协调和连续性的交接，以及扩大社区综合和整合护理服务的可及性。
