US study: maternal heart risk gaps widen with age, race and class

A US study of nearly 1.9 million births in California found that racial and socioeconomic inequalities in maternal cardiovascular health grow with age. Black women saw steeper age-related increases in conditions like hypertensive disorders than White women, even among the college-educated. The researchers argue that addressing structural factors earlier in life is key.

Bottom line — Black women's age-related risk of hypertensive disorders rose 27% per five years even among college-educated, per the study.

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• The study analysed 1,880,400 births in California from 2007 to 2019, including live births and stillbirths at 20 weeks or later, per the European Medical Journal.
• Hypertensive disorders of pregnancy occurred in 14.2% of Black women's births versus 9.2% for White women, the researchers reported.
• Non-optimal pre-pregnancy cardiovascular health affected 60.9% of Black women compared with 45.2% of White women, the study found.
• Among Black women with high-school education or less, each five-year age increase was tied to a 79% higher risk of chronic hypertension; for college-educated White women it was 41%, per the study.
• The authors caution the cross-sectional design cannot prove causation, but argue inequalities cannot be understood through age, race, or socioeconomic status alone.
• The study suggests interventions targeting structural determinants and chronic stressors earlier in life may be needed to reduce persistent maternal cardiovascular inequalities.

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