Maternal Deaths Due to Cardiovascular Disease Doubled in US Since 1999
Black women and those living in Southern states had the highest rates of maternal mortality.
Maternal mortality due to cardiovascular disease has more than doubled over the past 20 years in the United States, according to recent data presented at the American College of Cardiology's Annual Scientific Session.1 The findings also showed racial and geographic disparities, with Black women and those living in Southern states being impacted the most.
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Cardiovascular disease is the leading cause of death in the country, with 2200 Americans dying each day.2 Although men are more affected than women, cardiovascular disease is the primary cause of pregnancy-related mortality. Pregnancy-related mortality due to cardiovascular disease has been rising over time, due to various factors like advanced maternal age at pregnancy, and comorbid preexisting conditions such as diabetes and hypertension.3
READ MORE: Pharmacists’ Expertise in Contraceptive Counseling Amid Ongoing Challenges | APhA 2025
"We're heading in the wrong direction,” Mohammad Ahabab Hossain, MD, lead author on the study and a resident physician at Rutgers New Jersey Medical School, said in a release.4 “The United States is supposed to be a global leader in advancing health and medicine, and the fact that we still have pregnant women who are dying—often because of preventable causes—should sound alarm bells."
Investigators conducted a study to analyze rates of maternal mortality attributed to conditions such as high blood pressure, those related to dangerous blood clots, and those that weaken the heart's pumping ability. Data for the study was gathered from the CDC’s WONDER database, a freely accessible website for public health data sets. The researchers collected data from 1999 to 2022 and divided the number of cardiovascular-related maternal deaths by the total number of women of reproductive age.
The study found that the rate or maternal mortality increased from 3.6 per 1 million in 1999 to a peak of 10.5 per million in 2021. However, that number decreased slightly in 2022 to just under 9.1 per million. Rates of maternal mortality were particularly high in both 2020 and 2021, with researchers saying that this was likely due to limited prenatal care access during the COVID-19 pandemic. The greatest year over year increase occurred in 2018 after the nationwide adoption of standardized reporting of pregnancy status on death certificates.
From 2018 to 2022, Black women had a mortality rate of 21.9 per million compared to 7.1 per million among White women. Additionally, the South had the highest rate of any region in the country. Compared to a mortality rate of 5.4 per million in Western states, the Southern states had a rate of 12.1 per million. Investigators said these disparities could be caused by factors such as socioeconomic disadvantages, limited access to health care, and issues with trust in the health care system.
Investigators said that access to prenatal care clinics equipped to handle high-risk pregnancies will be key to reducing maternal mortality disparities. They added that clinicians and patients need to be aware of cardiovascular risk factors and take steps to control them, which can help prevent complications.
“Part of the reason this is happening is because heart disease and hypertension are becoming more and more prevalent, as are the conditions that are connected to heart disease, like diabetes and obesity,” Hossain said.4 “As a result, we wind up with more high-risk pregnancies. However, a lot of this is preventable. If a patient has a history of hypertension or other preexisting cardiovascular disease, that patient should be connected with a high-risk obstetrics clinic to receive the care they need."
READ MORE: Women's Health Resource Center
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