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For better or worse, the COVID-19 pandemic has changed the health care delivery landscape


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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