Reducing disparities in adverse pregnancy outcomes in the United States

Lochan M. Shah, Bhavya Varma, Khurram Nasir, Mary Norine Walsh, Roger S. Blumenthal, Laxmi S. Mehta, Garima Sharma

Research output: Contribution to journalReview articlepeer-review

3 Scopus citations


There is growing evidence that rural and racial disparities and social determinants of health (SDOH) impact adverse pregnancy outcomes (APOs) and overall maternal mortality in the United States. These APOs, such as preeclampsia, preterm birth, and intrauterine growth restriction, are in-turn associated with increased risk of future cardiovascular disease (CVD) later in life. Importantly, SDOH such as socioeconomic disadvantages, poor health literacy, transportation barriers, lack of access to adequate health care, food insecurity, and psychosocial stressors have cascading effects on APOs and downstream cardiovascular health. These SDOH are also deeply intertwined with and compounded by existing racial and rural disparities. Pregnancy thus provides a unique opportunity to identify at-risk women from a social determinants perspective, and provide early interventions to optimize long-term CVD and mitigate cardiovascular health disparities. Addressing the challenges posed by these disparities requires a multi-pronged approach and involves national, regional, and individual level solutions. Eliminating disparities will necessitate a nationwide obligation to ensure health care equity via enhanced health insurance coverage, resource investment, and public and clinician accountability.

Original languageEnglish (US)
Pages (from-to)92-102
Number of pages11
JournalAmerican Heart Journal
StatePublished - Dec 2021

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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