Pregnancy complications affect up to one in three pregnancies and are increasingly linked to future chronic disease. For example, preeclampsia is associated with a doubled risk of cardiovascular disease, the leading cause of death in the U.S., and gestational diabetes is associated with a seven-fold increased risk of type 2 diabetes. While guidelines recommend preventive care starting within the first postpartum year to address such pregnancy-related health risks, the connections between pregnancy health and future health are often neglected.
In a Viewpoint in the Journal of General Internal Medicine, researchers warn that health care delivery and access issues related to the COVID-19 pandemic may worsen pregnancy and chronic disease-related inequities.
“Missed opportunities to address pregnancy-related chronic disease risk not only threaten individuals’ wellbeing; they perpetuate long-term health inequities,” said corresponding author Mara Murray Horwitz, MD, assistant professor medicine, section of general internal medicine at Boston University School of Medicine.
Murray Horwitz argues that if pregnancy-related chronic disease risk management does not improve, the current pandemic may create a future pandemic of preventable chronic diseases. She discusses major challenges and potential solutions to pregnancy-related chronic disease risk management in primary care, taking into account new challenges and opportunities during the COVID-19 era. She highlights the need for innovations in care coordination and health care delivery, including virtual medicine and self-monitoring tools. She also discusses a necessary shift in the perceived role of primary care clinicians in postpartum care.
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