# Preconception contributors to severe maternal morbidity in black and white women

> **NIH NIH R21** · MAGEE-WOMEN'S RES INST AND FOUNDATION · 2020 · $231,193

## Abstract

ABSTRACT
Adverse pregnancy outcomes (APO), including hypertensive disorders of pregnancy, preterm
birth, and gestational diabetes, are associated with short- and long-term cardiovascular risk in
mothers. The urgency of these associations is amplified by an `unexplained epidemic' of
increased CVD risk among young adult women (age 35 to 55) (ref; Vaccarino, Circulation 2019).
These CVD trends coincide with unexplained increases in severe maternal morbidity (SMM) and
mortality in the U.S, the dominant cause being cardiovascular in nature. (Creanga 2017) Further
complicating these trends of deteriorating cardiovascular health in young adult women are
profound and persistent race disparities, with black women having rates of CVD and severe
maternal morbidity 2 to 3 times higher than white women (Peterson 2019). Social determinants
of health including stress, discrimination and access to care are also known contributors to CVD
risk and SMM, but to date these have not been studied in a comprehensive and synergistic
fashion to understand precursors and contributors to racial disparities in SMM. Our on-going
NHLBI-funded study, Shared antecedents to preterm birth and CVD in women (R21HL145419),
is uniquely poised to disentangle these questions. It also provides a unique opportunity to
expand research on the leading causes of maternal mortality and severe maternal morbidity in
order to strengthen evidence-based care and prevention strategies and improve maternal
health. The CARDIA study has conducted up to 9 in-person exams among 2,787 women (50%
Black), of whom 1,362 delivered 2,389 births from baseline and up to the year 30 follow-up
exam (1985-2015). There are extensive longitudinal data on blood pressure, lipids, glycemia,
cardiac structure, adiposity, lifestyle, metabolic diseases, and subclinical atherosclerosis.
Uniquely, these exams include longitudinal data on stress, social determinants of health and
discrimination. We propose to assemble these features to study 900 CARDIA women from both
before and after pregnancies. We hypothesize that cardiometabolic, inflammatory and
social stressors prior to pregnancy converge and contribute to racial disparities in
severe maternal morbidity and premature CVD. Assessing pre-conception bio-behavioral
markers will provide novel insights into the pathophysiology of pregnancy-associated morbidity
as well as identify modalities to mitigate CVD in women of reproductive age.

## Key facts

- **NIH application ID:** 10200386
- **Project number:** 3R21HL145419-02S1
- **Recipient organization:** MAGEE-WOMEN'S RES INST AND FOUNDATION
- **Principal Investigator:** Janet M Catov
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $231,193
- **Award type:** 3
- **Project period:** 2019-04-01 → 2022-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10200386

## Citation

> US National Institutes of Health, RePORTER application 10200386, Preconception contributors to severe maternal morbidity in black and white women (3R21HL145419-02S1). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10200386. Licensed CC0.

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