Heart disease No. 1 cause of pregnancy-related deaths in California

Heart disease is the leading cause of women's pregnancy-related deaths in California - but nearly one-third could be prevented, according to research presented at the American Heart Association's Scientific Sessions 2013.

Maternal death rates have been increasing in California and the United States since the mid-1990s, according to statistics from the California Department of Public Health.

“Women who give birth are usually young and in good health,” said Afshan B. Hameed, M.D., the study’s lead researcher and associate professor of clinical cardiology, obstetrics and gynecology at the University of California, Irvine. “So heart disease shouldn’t be the leading cause of pregnancy-related deaths, but it is.”

She said the results likely apply to the rest of the United States.

There were 2.1 million live births in California from 2002-2005.

Researchers analyzed medical records of 732 women who died from all causes while pregnant or within one year of pregnancy and found that:

209 deaths were pregnancy-related.

52 (about one quarter) of the pregnancy-related deaths were from some form of cardiovascular disease. Of note, only 6 percent had been diagnosed with a heart condition prior to the pregnancy.
33 (or two-thirds) of the cardiovascular-related deaths were from cardiomyopathy - a serious disease in which the heart muscle is weakened and can lead to heart failure, irregular heartbeats, heart valve problems and death.

Maternal mortality – The global picture

The death of a woman who leaves behind a young family has devastating consequences for these survivors, with increased chances of disadvantage, illness and premature death, especially in poorer societies. Maternal death (death during pregnancy or less than 42 days after the end of a pregnancy) is also the outcome measure that causes serious concern to public health authorities and maternity care clinicians. No health outcome shows such large discrepancies between rich and poor nations. The most recent reliable figures show more than hundred-fold differences in maternal mortality ratios (MMR – deaths per 100 000 live births). For example, for 2008 the MMRs in Italy, Egypt, South Africa, Zimbabwe, Lesotho, and Afghanistan were estimated at 4, 43, 237, 624, 964 and 1595 respectively. The Millennium Development Goal (MDG) 5a has as its target the reduction of maternal mortality by 75% from 1990 to 2015. A number of middle-income countries have made good progress, and Egypt, for example, has already attained its MDG 5a goal. South Africa, also a middle-income country, has unfortunately seen an increase in maternal mortality, related mainly to deaths caused by HIV and AIDS. Given the 1990 figure from this source, South Africa needs to reduce its MMR to 30 by 2015, clearly an unattainable goal at present. Progress towards MDG 5a is also not good in other African countries south of the Sahara, although recent small reductions from very high levels of mortality have been shown.