DALLAS - A new scientific statement from the American Heart Association underscores the critical importance of early detection and timely treatment of heart failure in pregnant and postpartum women to prevent serious complications, including irregular heartbeat, stroke, and death. Published today in the Association's flagship journal Circulation, the statement highlights that heart failure symptoms, such as shortness of breath, fatigue, and swelling, are often mistaken for normal pregnancy experiences, leading to delayed diagnosis and life-threatening consequences for both mother and baby.
According to the statement, nearly 1 in 4 women aged 20-44 currently have some type of cardiovascular disease, and heart disease is now one of the leading causes of pregnancy-related death in the U.S., based on data from the CDC's Pregnancy Mortality Surveillance System. The true prevalence of heart failure during the perinatal period remains unknown, but the risks are substantial. Women who are pregnant and have heart failure are about 32 times more likely to die around the time of delivery compared to pregnant women without heart failure.
“Heart failure during and after pregnancy is often hiding in plain sight,” said Demilade A. Adedinsewo, M.D., M.P.H., chair of the statement writing group. “By recognizing symptoms earlier and initiating appropriate treatment, especially in the postpartum period, clinicians and health systems have a powerful opportunity to prevent serious complications and save mothers’ lives.”
The statement emphasizes that the first year after delivery is a particularly high-risk time for women to develop heart failure. Referrals from obstetric care specialists to cardiology or primary care are essential components of high-quality postpartum care beyond the traditional six-week period. Continued monitoring may include home visits and telemedicine for remote symptom assessments.
Significant disparities exist in perinatal heart failure risk and outcomes. Black adults have about a 19% higher risk of developing heart failure than white adults, and Black and Native American women are more frequently diagnosed with peripartum cardiomyopathy (PPCM). Heart failure contributed to 14.5% of pregnancy-related deaths among American Indian/Alaska Native women and 14.2% among Black women.
“Improving postpartum care is essential to protecting maternal health. Standardized screening, listening carefully to patient concerns and improved access to care are crucial to help improve outcomes for mothers and their families,” added Adedinsewo.
The statement calls for a multidisciplinary cardio-obstetrics team to provide continuous monitoring and treatment. Achieving optimal cardiovascular health, as outlined by the American Heart Association's Life's Essential 8 metrics, is increasingly recognized as important before, during, and after pregnancy.
For more information on the American Heart Association's efforts, visit their Pregnancy and Maternal Health page. Follow news from the Association on X at @HeartNews.
