Negative Social Conditions Raise Heart Disease Risk in Pregnant Women

Pregnant women in the U.S. who face adverse social conditions where they live, work, learn and play are at higher risk for poor heart health, a new study suggests.

That can lead to early cardiovascular disease and death – and it can affect their children’s health, says senior study author Dr. Khurram Nasir, division chief of Cardiovascular Prevention and Wellness at Houston Methodist DeBakey Heart & Vascular Center in Texas. “We need to identify and work on the social risks that are truly impacting their cardiovascular risks.”

Cardiovascular disease is driving a rise in the maternal death rate, which has been steadily rising over the past few decades. It now accounts for one-third of all pregnancy-related deaths. Recent years also have seen a rise in cardiovascular risk factors among pregnant women, including Type 2 diabetes, high blood pressure and obesity. At the same time, other poor pregnancy outcomes have been growing, such as preeclampsia, gestational diabetes, premature births and low birthweight babies.

The new study, published Tuesday in the Journal of the American Heart Association, measured risk factors for cardiovascular disease among pregnant women living under multiple adverse social conditions, including economic instability, low education levels, high psychological distress, unstable housing, food insecurity, insufficient access to quality health care, and a lack of social support. These factors are collectively referred to as the social determinants of health.

While other studies have looked at individual factors affecting the social conditions under which pregnant women live, Nasir says this is the first to look at the cumulative impact of those conditions upon pregnant women’s heart health.

“We took a more robust look at the issue than just looking at income and access to health care,” Nasir, a professor of cardiology at Houston Methodist Academic Institute shares. “There are many other factors that used to get ignored. But it’s very hard to disentangle the individual risks, which are interconnected. We needed a more comprehensive approach in capturing them.”

Nasir and his team looked at six categories of social determinants affecting the lives of 1,433 pregnant women, scoring 38 individual sociodemographic variables. Using data from the National Health Interview Survey, their cardiovascular health was rated based on the presence of risk factors such as high blood pressure, obesity, Type 2 diabetes, high cholesterol, current smoking and insufficient physical activity.

Overall, they found about one-third of the women had less than optimal heart health, no matter their sociodemographic scores. But women facing the greatest cumulative burden of negative social conditions were twice as likely to have two or more risk factors for