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Maternal Mortality in the United States and the HOPE Registry

  • Pregnancy and Cardiovascular Disease (N Scott, Section Editor)
  • Published:
Current Treatment Options in Cardiovascular Medicine Aims and scope Submit manuscript

Abstract

Purpose of review

Maternal mortality in the United States is highest among all developed nations and continues to rise. The leading cause of morbidity and mortality during pregnancy and the postpartum period is cardiovascular disease. While there are large European and Canadian studies exploring the care and outcomes of moms with heart disease in pregnancy, there are no large prospective studies to guide the care of this growing group of patients in the US. We review the current approach to the management of patients with heart disease in pregnancy and the gaps in knowledge thereof.

Recent findings

Currently, antenatal management and delivery planning are highly variable for patients with heart disease in pregnancy and maternal risk models’ application to the US patient population is limited by their derivation from an international cohort of patients and their focus on patients with congenital heart disease. As the need for interdisciplinary care between cardiologists and obstetricians becomes evident, and as broad research efforts within this space are very much needed, we propose a research collaborative called the Heart Outcomes in Pregnancy: Expectations (HOPE) for Mom and Baby Registry. The HOPE Registry aims to address key clinical questions surrounding the preconception period, antenatal care, delivery planning and outcomes, and long-term postpartum care and outcomes of these unique patients.

Summary

We have made progress in recent years by recognizing the clinical need to address and standardize the management of patients with heart disease in pregnancy. We now must initiate and propel US-based cardio-obstetrics research to address key gaps in knowledge and variability in the care of patients with heart disease in pregnancy.

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Authors and Affiliations

  1. Saint Luke’s Health System, 4401 Wornall Road, Cardiovascular Outcomes Research Department 9th Floor, Kansas City, MO, 64111, USA

    Anna Grodzinsky MD, Karen Florio DO, John A. Spertus MD MPH, Tara Daming MD, Laura Schmidt MD, John Lee MD, Valerie Rader MD, Lynne Nelson FNP, Rebecca Gray RN, Darcy White RN, Kate Swearingen FNP & Anthony Magalski MD

  2. University of Missouri-Kansas City, Kansas City, MO, USA

    Anna Grodzinsky MD, Karen Florio DO, John A. Spertus MD MPH, Tara Daming MD, Laura Schmidt MD, John Lee MD, Valerie Rader MD, Lynne Nelson FNP, Rebecca Gray RN, Darcy White RN, Kate Swearingen FNP & Anthony Magalski MD

Authors
  1. Anna Grodzinsky MD
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  2. Karen Florio DO
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  3. John A. Spertus MD MPH
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  4. Tara Daming MD
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  5. Laura Schmidt MD
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  6. John Lee MD
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  7. Valerie Rader MD
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  8. Lynne Nelson FNP
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  9. Rebecca Gray RN
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  11. Kate Swearingen FNP
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Corresponding author

Correspondence to Anna Grodzinsky MD.

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The authors declare that they have no conflict of interest.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Pregnancy and Cardiovascular Disease

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Grodzinsky, A., Florio, K., Spertus, J.A. et al. Maternal Mortality in the United States and the HOPE Registry. Curr Treat Options Cardio Med 21, 42 (2019). https://doi.org/10.1007/s11936-019-0745-0

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  • DOI: https://doi.org/10.1007/s11936-019-0745-0

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