Economic, Social Circumstances and Pregnant Women
A study led by investigators in the Smidt Heart Institute at Cedars-Sinai found that women who are single, have government health insurance or possess low health literacy at the time of their first pregnancy are more likely to develop health conditions that can lead to cardiovascular problems.
The findings are published in American Heart Journal Plus: Cardiology Research and Practice.
"Cardiovascular disease is the number one cause of death for women in the United States,” said Natalie A. Bello, MD, MPH, associate professor of Cardiology and director of Hypertension Research at the Smidt Heart Institute and first author of the study. "If we identify women who are at risk for developing cardiometabolic health issues while they're pregnant, we may be able to intervene to prevent them from developing full-blown disease."
The health conditions the investigators studied are collectively known as metabolic syndrome and give an overall picture of a person’s cardiometabolic health. They include high blood sugar, high blood pressure, low levels of HDL (“good”) cholesterol in the blood, high levels of fat called triglycerides in the blood and a large waist circumference. A person with three or more of these conditions would be diagnosed with metabolic syndrome and be at increased risk for developing heart disease, diabetes, stroke and other health issues.
For this study, Bello and colleagues conducted interviews with 4,484 pregnant patients from eight academic medical centers and tracked their health for an average of three years. Overall, 13.6% of the study participants developed metabolic syndrome.
Pregnant women who reported being single, having government or military insurance or who were found through a validated tool to possess low health literacy were more likely to develop metabolic syndrome. Conversely, pregnant women who reported having a higher household income or a bachelor’s degree or higher level of education were less likely to develop metabolic syndrome.
"These findings might spur clinicians to think about how we can support pregnant women beyond just offering clinical advice or prescribing a pill,” Bello said. “Perhaps interventions can involve connecting patients with social services to help them with things like buying healthy groceries or get support to attain a higher level of education."
Bello said she was interested in studying how social factors at the time of pregnancy might impact a woman’s health trajectory.
"We know social determinants like a person’s level of education and the environment in which they were born or currently live in can have a dramatic impact on health and ability to access care," she said.
Bello also noted that previous studies have documented how a mother’s health influences the health of her family.
"If we support a mother, we may prevent a child from developing diabetes, obesity or other preventable illnesses," she said.
Funding: This study was funded by the National Institutes of Health/Office of Research on Women's Health Building Interdisciplinary Research Careers in Women's Health (BIRCWH) program, by a cooperative agreement funding from the National Heart, Lung, and Blood Institute; the Eunice Kennedy Shriver National Institute of Child Health and Human Development; the National Institutes of Health/Office of Research on Women's Health; the National Institutes of Health/Office of Behavioral and Social Sciences Research; the National Center for Advancing Translational Sciences; the Barbra Streisand Women's Cardiovascular Research and Education Program; the Erika J. Glazer Women's Heart Research Initiative; and Cedars-Sinai Medical Center.