Patients with preeclampsia, a high blood pressure condition that can occur during pregnancy or after delivery, can minimize health risks by having regular follow-up visits after delivery.
Malamo E. Countouris, assistant professor of medicine at the University of Pittsburgh School of Medicine, is the lead author of a recently published national study of postnatal care for patients with preeclampsia. The study examined how socioeconomic factors may influence racial and ethnic disparities in primary care or cardiac follow-up.
The study, published in August in the Journal of the American Heart Association, shows that black and Hispanic women diagnosed with preeclampsia are less likely to see a primary care physician or cardiologist in the first year after delivery than white women, potentially putting them at higher cardiovascular risk. The study also showed that income and education contribute to this disparity.
Preeclampsia carries a higher risk of high blood pressure, heart failure and stroke and occurs in an estimated 5 to 8% of all pregnancies. It is one of the leading causes of pregnancy-related deaths, according to the Centers for Disease Control and Prevention.
Regular follow-up examinations after birth with a doctor or cardiologist can provide sufficient time to control blood pressure and optimize long-term cardiovascular health.
Researchers from the University of Pittsburgh, Brown University and the University of Maryland used an ethnically and geographically diverse national database to identify 18,050 insured adults diagnosed with preeclampsia. Of these, 11.7% were non-Hispanic black and 14.8% were of Hispanic descent.
The researchers compared the frequency of visits to a primary care physician or cardiologist within one year after delivery by race and ethnicity and concluded that blacks and Hispanics with higher levels of education and in higher income brackets were more likely to see a primary care physician or cardiologist after delivery.
The study suggests that public health interventions could help reduce barriers and eliminate disparities in postpartum care, particularly among Black and Hispanic people with lower levels of education or lower income. Structural changes in the health care system, social and societal 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 with public insurance, Medicaid coverage ends 60 days after delivery in many states, so providing continuous health insurance for up to a year after birth could also help reduce disparities in care.
