{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T22:26:10Z","timestamp":1791930370999,"version":"4.3.4"},"reference-count":83,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"19","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2025,10,7]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">To address the maternal health crisis in the United States, it is important to closely examine the epidemiologic trends of and racial and ethnic disparities in maternal cardiovascular health.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              We used statewide birth hospitalization and vital statistics records from California (2007\u20132019; N=6\u2009117\u2009886) to examine the prevalence, trends, and racial and ethnic disparities of hypertensive disorders of pregnancy overall (ie, chronic hypertension, gestational hypertension\/preeclampsia, or eclampsia), and chronic hypertension and gestational hypertension\/preeclampsia separately. We also examined a construct indicating ideal cardiovascular health before and during pregnancy using the subset of data with information available on clinical cardiovascular health indicators (ie, hypertension, diabetes, smoking, body mass index [kg\/m\n              <jats:sup>2<\/jats:sup>\n              ], and gestational weight gain adjusted for gestational age; N=5\u2009636\u2009185). To quantify racial and ethnic disparities, we used modified Poisson regression models (with robust standard errors), controlling for sociodemographic characteristics, pregnancy\u2010related factors, and year fixed effects.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Results<\/jats:title>\n            <jats:p xml:lang=\"en\">The age\u2010standardized prevalence of adverse outcomes worsened over time for all racial and ethnic groups. Compared with non\u2010Hispanic White (White) individuals, non\u2010Hispanic Black mothers had higher risk of hypertensive disorders of pregnancy (risk ratio [RR], 1.60 [95% CI, 1.59\u20131.62]), including chronic hypertension (RR, 2.34 [95% CI, 2.29\u20132.38]) and gestational hypertension\/preeclampsia (RR, 1.50 [95% CI, 1.49\u20131.52]). American Indian\/Alaska Native mothers were less likely to have ideal cardiovascular health both before (RR, 0.66 [95% CI, 0.65\u20130.67]) and during pregnancy (RR, 0.80 [95% CI, 0.78\u20130.81]) compared with White mothers. These differences persisted throughout the study period.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Our findings reveal stark racial and ethnic disparities in maternal cardiovascular health, highlighting the urgent need to investigate and address their structural determinants.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.124.039295","type":"journal-article","created":{"date-parts":[[2025,9,25]],"date-time":"2025-09-25T12:14:39Z","timestamp":1758802479000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Trends and Racial and Ethnic Disparities in Maternal Cardiovascular Health in California"],"prefix":"10.1161","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0879-6176","authenticated-orcid":false,"given":"Elleni M.","family":"Hailu","sequence":"first","affiliation":[{"name":"Stanford University","place":["Palo Alto, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzan L.","family":"Carmichael","sequence":"additional","affiliation":[{"name":"Stanford University","place":["Palo Alto, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9566-3047","authenticated-orcid":false,"given":"Jonathan M.","family":"Snowden","sequence":"additional","affiliation":[{"name":"Oregon Health & Science University\u2010Portland State University","place":["Portland, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2215-4273","authenticated-orcid":false,"given":"Audrey","family":"Lyndon","sequence":"additional","affiliation":[{"name":"Rory Meyers College of Nursing, New York University","place":["New York, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7562-7850","authenticated-orcid":false,"given":"Elliott","family":"Main","sequence":"additional","affiliation":[{"name":"School of Medicine, Stanford University","place":["Palo Alto, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9795-9338","authenticated-orcid":false,"given":"Mahasin S.","family":"Mujahid","sequence":"additional","affiliation":[{"name":"School of Public Health, University of California, Berkeley","place":["Berkeley, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.115.06357"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000961"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2020.07.053"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2021.0247"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.118.011394"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.16932"},{"key":"e_1_3_1_8_2","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6835a3"},{"key":"e_1_3_1_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/HYP.0000000000000208"},{"key":"e_1_3_1_10_2","doi-asserted-by":"publisher","DOI":"10.1111\/ppe.13063"},{"key":"e_1_3_1_11_2","doi-asserted-by":"publisher","DOI":"10.1111\/ppe.13059"},{"key":"e_1_3_1_12_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.121.021616"},{"key":"e_1_3_1_13_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.120.018155"},{"key":"e_1_3_1_14_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-018-1959-y"},{"key":"e_1_3_1_15_2","doi-asserted-by":"publisher","DOI":"10.1111\/ppe.12995"},{"key":"e_1_3_1_16_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0260703"},{"key":"e_1_3_1_17_2","doi-asserted-by":"publisher","DOI":"10.1097\/EDE.0b013e318225c960"},{"key":"e_1_3_1_18_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000582"},{"key":"e_1_3_1_19_2","first-page":"1","volume-title":"Maternal Mortality and Maternity Care in the United States Compared to 10 Other Developed Countries","author":"Tikkanen R","year":"2020","unstructured":"Tikkanen R, Gunja MZ, Fitzgerald M, Zephyrin L. 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