Racial/Ethnic Disparities in Screening for and Awareness of High Cholesterol Among Pregnant Women Receiving Prenatal Care

Abstract

Background Atherosclerotic cardiovascular disease remains a leading cause of morbidity and mortality among women, with younger women being disproportionately affected by traditional cardiovascular risk factors such as dyslipidemia. Despite recommendations for lipid screening in early adulthood and the risks associated with maternal dyslipidemia during pregnancy, many younger women lack access to and utilization of early screening. Accordingly, our objective was to assess the prevalence of and disparities in lipid screening and awareness of high cholesterol as an atherosclerotic cardiovascular disease risk factor among pregnant women receiving prenatal care. Methods and Results We invited 234 pregnant women receiving prenatal care at 1 of 3 clinics affiliated with the University of Pennsylvania Health System to complete our survey. A total of 200 pregnant women (86% response rate) completed the survey. Overall, 59% of pregnant women (mean age 32.2 [±5.7] years) self‐reported a previous lipid screening and 79% of women were aware of high cholesterol as an atherosclerotic cardiovascular disease risk factor. Stratified by racial/ethnic subgroups, non‐Hispanic Black women were less likely to report a prior screening (43% versus 67%, P =0.022) and had lower levels of awareness (66% versus 92%, P <0.001) compared with non‐Hispanic White women. Non‐Hispanic Black women were more likely to see an obstetrician/gynecologist for their usual source of non‐pregnancy care compared with non‐Hispanic White women (18% versus 5%, P =0.043). Those seeing an obstetrician/gynecologist for usual care were less likely to report a prior lipid screening compared with those seeing a primary care physician (29% versus 63%, P =0.007). Conclusions Significant racial/ethnic disparities persist in lipid screening and risk factor awareness among pregnant women. Prenatal care may represent an opportunity to enhance access to and uptake of screening among younger women and reduce variations in accessing preventive care services.

Social Determinants of Suboptimal Cardiovascular Health Among Pregnant Women in the United States

“… 19 , 20 , 21 Second, there is a need for expansion of prepregnancy assessment of cardiovascular risk factors, such as implementing cholesterol screening during the first trimester before expected changes in lipid metabolism and their management during pregnancy. 36 , 52 , 53 Additionally, there needs to be improved education of clinicians about racial and ethnic disparities and impact of SDOH on maternal outcomes, cultural competency, and better reporting of the outcomes and quality of care in those with unfavorable SDOH through electronic health records. 17 , 54 , 55 …”

Pre-pregnancy check-up of maternal vascular status and associated phenotype is crucial for the health of mother and offspring

“…During pregnancy, maternal cardiovascular system is exposed to highly increased haemodynamic stress that significantly impacts health status of mother and offspring [8,9]. Resulting from sub-optimal maternal health conditions overlooked in pre-pregnancy time, progressive abnormalities can be expected in the foetal development and maternal health status during pregnancy and postpartum.…”

Antithrombotic and antiplatelet effects of plant-derived compounds: a great utility potential for primary, secondary, and tertiary care in the framework of 3P medicine

“…During pregnancy, the maternal cardiovascular system is exposed to hemodynamic stress which is a significant risk factor influencing the health status of the mother and offspring [ 173 , 174 ]. To this end, sub-optimal maternal health conditions overlooked in pre-pregnancy time may lead to progressive abnormalities in the fetal development and maternal health status during pregnancy and postpartum.…”