Heart disease is the top
cause of pregnancy-related deaths in California, but almost one-third of those
deaths could be prevented, a new study suggests.
"Women who give birth
are usually young and in good health. So heart disease shouldn't be the leading
cause of pregnancy-related deaths, but it is," lead researcher Dr Afshan
Hameed, an associate professor of clinical cardiology, obstetrics and gynaecology
at the University of California, Irvine, said in an American Heart Association
(AHA) news release.
From 2002 to 2005, there
were 2.1 million live births in California. Hameed and her colleagues analysed
the medical records of 732 women in the state who died from all causes while
pregnant or within one year of pregnancy, and found that 209 of those deaths
About one-quarter (52) of
the pregnancy-related deaths were from some form of heart disease. Only 6
percent of these women who died had been diagnosed with a heart condition
before the pregnancy.
Two-thirds (33) of the
heart-related deaths were from cardiomyopathy, a disease in which the heart
muscle is weakened, which can lead to heart failure, irregular heartbeats,
heart valve problems and death.
Women most likely to die
from pregnancy-related heart disease were black, obese or were substance
abusers during pregnancy. Nearly one-fourth of the pregnant women who died of
heart disease had been diagnosed with high blood pressure during their
In about two-thirds of the
deaths, the diagnosis was either incorrect or delayed or doctors gave
ineffective or inappropriate treatments, according to the researchers.
One-third of the patients who died had failed to seek or had delayed care, 10%
refused medical advice and 27% did not recognise their symptoms as
The findings, scheduled for
presentation Sunday at the AHA's annual meeting in Dallas, likely apply to the
rest of the United States, according to Hameed.
"Women should attain
and maintain proper weight before and during pregnancy, and talk to their
doctors if they have personal or family histories of heart disease," she
Maternal death rates rising
"And health care
providers should be referring pregnant women who complain of symptoms
consistent with cardiac disease to specialists, especially when these risk
factors are present. Women with evidence of substance abuse should receive
early referral for treatment," Hameed added.
However, it is impossible
to be certain whether earlier diagnosis and intervention would have prevented
death in these cases "as missed cues to the presence of heart disease were
common", she said.
Because the study was
presented at a medical meeting, the data and conclusions should be viewed as
preliminary until published in a peer-reviewed journal.
Maternal death rates have
been rising in California and the United States since the mid-1990s, according
to the California Department of Public Health.
The Cleveland Clinic has
more about heart diseases and pregnancy.