Black Box Warning: Cardiovascular Complications Make Motherhood Unsafe for African American Women

BACKGROUND: In the United States, cardiovascular disease and its complications in pregnancy is the leading killer in mothers. The black maternal mortality rate is quadruple the rate among white women. MAIN BODY: The reasons for this staggering discrepancy hinge on two central issues: First, black women are more likely to have pre-existing cardiovascular morbidity that increase the risk of maternal mortality. Second, black women are more likely to experience adverse pregnancy outcomes including small for gestational age, gestational diabetes and preeclampsia. These perinatal complications put them at risk for developing long-term cardiovascular disease. CONCLUSIONS: This article is a call to action to recognize that adverse pregnancy outcomes represent an opportunity to intervene in order to change the long-term cardiovascular health of black women.