Socioeconomic Disparities in Adverse Cardiovascular Pregnancy Outcomes: The Intersection of Race and Socioeconomic Status

Abstract

Background: Adverse pregnancy outcomes (APOs) are strongly associated with an increased risk of long-term cardiovascular disease (CVD), with physiological adaptations during pregnancy, such as vascular remodeling and endothelial dysfunction, possibly contributing to an elevated lifetime CVD risk. This review explores the complex interplay between APOs and long-term CVD risk, emphasizing how racial disparities and socioeconomic status (SES) shape maternal cardiovascular health. Methods: A comprehensive review of existing literature was conducted to evaluate the association between APOs and long-term CVD risk. This review also examines the influence of SES and racial disparities on maternal cardiovascular health, highlighting their roles in modifying disease progression and health care access. Results: Approximately 29% of women experience pregnancy complications, including gestational diabetes and hypertensive disorders, which are associated with at least a twofold increase in subsequent cardiovascular event risk. Socioeconomic factors play a critical role in shaping prenatal care quality and treatment adherence, as women from lower SES backgrounds, due to systemic barriers, face a heightened risk of APOs. Racial disparities further exacerbate these risks, with Black women experiencing disproportionately higher maternal mortality and APO rates compared with White women. Conclusions: This review underscores the intersection of race and SES in shaping maternal health disparities and long-term CVD risk. Targeted interventions to address these inequities by addressing social determinants of health are necessary. Future research should focus on elucidating the mechanisms linking SES and race to CVD following APOs, developing strategies to mitigate disparities, and conducting longitudinal studies to track CVD progression in affected populations.