Impact of Cardiovascular Disease and Health Disparities in the Obstetric Population

Pregnant individuals represent a uniquely vulnerable population, as the physiologic demands of pregnancy can unmask or worsen underlying conditions while simultaneously influencing fetal development. Building on prior discussions of cardiovascular adaptation during pregnancy, this review examines maternal and fetal health through a public health lens, emphasizing how social determinants of health shape obstetric outcomes. Although normal cardiovascular changes promote fetal growth, these shifts can exacerbate undiagnosed or poorly controlled conditions, leading to higher rates of complications. Research consistently shows that these negative outcomes are not equitably distributed. Significant disparities exist across racial and ethnic groups, reflected in metrics such as preterm birth, maternal morbidity, and cardiovascular complications. African American, Native Hawaiian or Pacific Islander, and American Indian or Alaska Native populations experience markedly higher rates of adverse outcomes compared with White counterparts. These patterns reflect broader structural factors, including inequities in housing, access to care, environmental exposures, and socioeconomic status. Structural racism further compounds these disparities by influencing health behaviors, community resources, and clinical interactions. Understanding these themes provides essential context for addressing maternal health inequities. Through improved recognition of social determinants, clinicians and policymakers can implement targeted strategies aimed at prevention, early intervention, and equitable care delivery. The insights summarized here support efforts to reduce the disproportionate health burden borne by underserved communities and highlight the need for systemic change to protect maternal and child health.