Patients with preeclampsia, a high blood pressure disorder that can occur during pregnancy or postpartum, can minimize the health risk by seeking regular follow-up care after delivery.
Malamo E. Countouris, assistant professor of medicine, University of Pittsburgh School of Medicine, is the lead author of a recently published national study on the postpartum care of patients with preeclampsia that examined how socioeconomic factors can influence racial and ethnic differences in primary care or cardiology follow-up.
Published in August in the Journal of the American Heart Association, the study shows that Black and Hispanic individuals diagnosed with preeclampsia are less likely than white individuals to visit a primary care physician (PCP) or cardiologist within the first year after delivery, potentially putting them at increased cardiovascular risk. It further showed that income and educational attainment factored into the disparity.
Preeclampsia carries a higher risk of elevated blood pressure, heart failure and stroke and occurs in an estimated 5% to 8% of pregnancies. According to the Centers for Disease Control and Prevention, it is one of the leading causes of pregnancy-related death.
Regular postpartum follow-up with a PCP or cardiologist provides a dedicated time to address blood pressure management and optimize cardiovascular health over the longer term.
Researchers from the University of Pittsburgh, Brown University and the University of Maryland used a racially and geographically diverse national database to identify 18,050 insured adults diagnosed with preeclampsia, of whom 11.7% were non-Hispanic Black and 14.8% were of Hispanic ethnicity.
Researchers compared occurrence of a postpartum visit with a PCP or cardiologist within one year after delivery by race and ethnicity and concluded that Black and Hispanic people with higher education attainment and in higher income brackets had a higher likelihood of having a postpartum primary care or cardiology visit.
The study suggests that public health interventions could help reduce barriers and improve inequities in postpartum follow-up, particularly among Black and Hispanic individuals with lower education or lower income. Structural changes to the health care system, social and society factors, and individual education could help people with limited social resources. Standardized care protocols that minimize barriers to appointment attendance, such as using virtual visits and remote blood pressure monitoring, could help reduce racial disparities. For those who are publicly insured, Medicaid coverage ends in many states 60 days after delivery, so providing continuous health care insurance coverage for up to one year postpartum could also help reduce inequities in care.