Maternal Cardiac Deaths Double, Impacting Black Women Most

Maternal deaths due to cardiovascular disease (CVD) have more than doubled in the US over the past 2 decades, with Black women and those living in Southern states bearing a disproportionate share of the burden, according to new research.¹

These findings will be presented on Saturday, March 29, at the American College of Cardiology (ACC) Annual Scientific Session in Chicago, IL.

Researchers analyzed national mortality data from 1999 to 2022 and found the age-adjusted mortality rate (AAMR) for CVD-related maternal deaths rose from 3.62 to 9.08 deaths per 1 million women of reproductive age.² In 2021, the peak rate reached 10.52 deaths per million, translating to an estimated 600 deaths in 2022 alone.

“Such unacceptable rates demand further investigation into identifying women at greatest risk, reducing disparities, and improving maternal outcomes of CVD,” the researchers said.

New research adds to the conversation around racial and regional gaps in maternal health. | Image credit: Prostock-studio – stock.adobe.com

Using data from the CDC WONDER database, researchers at Rutgers New Jersey Medical School identified 7581 maternal deaths from CVD between 1999 and 2022.¹ Causes included peripartum cardiomyopathy, hypertensive disorders of pregnancy, and thromboembolic events. The study defined maternal mortality as deaths occurring during pregnancy or soon after giving birth or up to a year after giving birth if the cause of death is related to the pregnancy.

The analysis showed stark disparities across both race and region. Between 2018 and 2022, Black women experienced an AAMR of 21.91 per million, more than triple that of White women, who had a rate of 7.10 per million.² Regionally, the South had the highest maternal CVD mortality, with an AAMR of 12.14, compared with 5.41 in the West.

These findings underscore a troubling trend in maternal health in the US, where overall maternal mortality rates already outpace those of other developed nations.¹ CVD remains the leading cause of death during and shortly after pregnancy, and the study suggests the crisis is deepening, particularly among vulnerable populations. According to Mohammad Ahabab Hossain, MD, resident physician at Rutgers New Jersey Medical School and lead author of the study, these findings are alarming and show that the country is “heading in the wrong direction.”

“The United States is supposed to be a global leader in advancing health and medicine, and the fact that we still have pregnant women who are dying—often because of preventable causes—should sound alarm bells,” said Hossain. “The fact that there are disparities based on race means we need to pay better attention to more vulnerable populations, specifically Black women.”

The study authors suggested multiple contributing factors, including increasing rates of hypertension, diabetes, and obesity—conditions that elevate cardiovascular risk and complicate pregnancies—and structural barriers such as limited access to specialized prenatal and postpartum care, particularly in Southern states.

The surge in mortality rates during 2020 and 2021 may further reflect pandemic-related disruptions in health care access. While changes in death certificate reporting may partially explain the increased mortality after 2018, the authors stress that “maternal deaths due to cardiovascular causes remain unacceptably high.”

Maternal CVD deaths are often preventable, as demonstrated in the study. Many of the affected individuals had pre-existing conditions that, if identified early and managed appropriately, could reduce the risk of severe complications or death. The researchers emphasized the need for better screening, preconception counseling, and referrals to high-risk obstetric care for patients with cardiovascular risk factors.

“If a patient has a history of hypertension or other pre-existing cardiovascular disease, that patient should be connected with a high-risk obstetrics clinic to receive the care they need,” Hossain said.

References

1. Maternal deaths from cardiovascular causes on the rise in U.S. News release. ACC. March 25, 2025. Accessed March 25, 2025. https://www.acc.org/About-ACC/Press-Releases/2025/03/25/10/19/Maternal-Deaths-From-CV-Causes-On-the-Rise-in-US
2. Hossain MA, Hussain A, Patel P, et al. Trends and disparities in cardiovascular-related maternal mortality in the United States: 1999-2022. Presented at: ACC.25, Chicago, IL; March 29-31, 2025.