Preventing Chronic Diseases After Complicated Pregnancies in the COVID-19 Era: a Call to Action for PCPs

Excerpt

Pregnancy complications affect up to one in three pregnancies and are increasingly linked to future chronic disease.¹ For example, preeclampsia is associated with a doubled risk of cardiovascular disease (CVD),¹ the leading cause of death in the USA, and gestational diabetes is associated with a 7-fold increased risk of type 2 diabetes.² Guidelines recommend preventive care starting within the first postpartum year to address such pregnancy-related health risks.^{2, 3} Unfortunately, the connections between pregnancy health and future health are often neglected. Only half of patients successfully transition to primary care in the year after a medically complicated pregnancy⁴; of those who do, a small minority receive care informed by their pregnancy complication.⁵ Missed opportunities to address pregnancy-related chronic disease risk not only threaten individuals’ wellbeing; they perpetuate long-term health inequities. Black, Hispanic, and low-income patients experience a double burden with higher rates of pregnancy complications and lower rates of postpartum follow-up, when compared with non-Hispanic White or higher-income patients.⁴ …