TMC PULSE

14 t m c » p u l s e | m a r c h 2 0 1 9 Q | What are the pregnancy-related contributions to lifelong cardiovascular problems? Does being pregnant take a toll on your heart? A | There are certain pregnancy complications that are very strongly associated with long-term cardiovascular risk. I use that word very purpose- fully. It's thought that perhaps for these particular women, pregnancy doesn't necessarily cause the problem, but it unmasks it. Pregnancy is like a stress test that lets you know that particular groups of women are at higher risk. It's a win- dow to future health. These are the women who have high blood pressure during pregnancy, preeclampsia—these women basically have a dou- bling of their risk of heart disease over the long term. Women who have gestational diabetes also have a higher risk for heart disease. Then there's another group of women who've maybe had high blood pressure for 10 years. Maybe they've developed diabetes. Those women have cardiac disease that can get significantly worse during a pregnancy. What we're really seeing in the postpartum period is about 10 percent of maternal deaths are caused by cardiac dysfunction—cardiomyopathy. There's something pathologic with the muscle of the heart. We don't completely understand why that's happening but we are seeing that more frequently. The good news is there are a lot of people now specifically studying that. We have experts on that in the task force. When we talk about older women, high blood pressure, obesity, those things are associated with maternal deaths more broadly. Q | In 2016, two independent reports suggested that maternal mortality rates in Texas had doubled over 10 years. A 2018 study, however, corrected those numbers and showed the rate was less than half of what was previously reported, in part because dozens of women were identified incorrectly on their death certificates as being pregnant at the time of death. How can we be sure this won't happen again? A | The Preventing Maternal Deaths Act of 2018, which became law in December, recognizes the need for state-based maternal mortality reviews that go beyond the vital statistics we get from death certificates. We saw how limited that was in Texas; the numbers were bad. When you can do state-based reviews like we have been doing, you get to move beyond the cause of death on a death certificate and really look in depth at what happened that day. That is the question the task force asks: Was this death preventable? And when we looked at our Texas data, we ended up grading about nearly 80 percent of our maternal deaths as preventable. That percentage varies from state to state. Most are 60 to 70 percent of deaths being preventable through reasonable actions. Q | Is this new law a kind of umbrella for all these state initiatives? A | Yes. It says everybody needs to do these detailed reports, and then it provided funding for a number of these states. We were able to start it here in Texas, but there were other states that had not been able to. Now they have resources that will help them build the infrastructure they need. Lisa M. Hollier, M.D., was interviewed by Pulse editor Maggie Galehouse. The conversation was edited for clarity and length. © 2019 Belmont Village, L.P. | ALF 106016, 030197 belmontvillage.com e Cmunity Built f Li. ® HUNTERS CREEK | 713-781-1505 WEST UNIVERSITY | 713-592-9200 Distinctive Residential Settings | Chef-Prepared Dining and Bistro | Pool Premier Health and Wellness Programs | Award-Winning Memory Care Professionally Supervised Therapy and Rehabilitation Services "It was difficult to reali• that they w•e dealing with a resident and not with a clo‡ friend relative." Cami can tell you the names of all of Mary's grandchildren — in order, from youngest to oldest. As a Belmont Village caregiver, she's passionate about enriching the lives of our residents through personal, skillful and thoughtful attention to every detail. From daily care to choosing the perfect birthday gift for the littlest grandchild, we're there for our residents whenever — and however — they need us. To us, they're family. - Voices of Belmont Village HC_WU_TMCPulse_Staff_GPTW_3_2019.indd 1 1/28/19 11:26 AM Spotlight

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