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News — Managing your blood pressure is an important part of a healthy lifestyle, but for women who are pregnant or planning to become pregnant in the new year, it is particularly crucial, a Rutgers obstetrician says.

“With a new Rutgers study showing how chronic hypertension has been driving maternal mortality in the United States, particularly among Black women, it’s more important than ever that we get the message out to women who are pregnant—or planning to be—about the importance of managing their blood pressure,” says Charletta Ayers, associate professor and vice chair of clinical services in the Department of Obstetrics, Gynecology and Reproductive Sciences at Rutgers Robert Wood Johnson Medical School. “It’s one of the reasons we’re focusing on hypertension-related issues for Maternal Health Awareness Day this year.”

The new study, by Cande V. Ananth and colleagues at Rutgers Robert Wood Johnson Medical School, showed that maternal mortality rates due to chronic hypertension have increased on average by approximately 9.2 percent per year over the past 40 years, with Black women at almost four-fold risk of maternal deaths from a hypertension-related cause.

According to the American Heart Association, approximately 10 percent of all pregnancies are affected by hypertensive disorders of pregnancy—a condition that increases women’s risk of developing cardiovascular disease later in life (on average, twice as likely), as well as puts them at greater risk of developing hypertension, stroke and type 2 diabetes following pregnancy. Women who become pregnant when they are obese have six-times greater odds of developing gestational hypertension compared to women who are at an ideal weight when they become pregnant, according to the Academy of Nutrition and Dietetics. 

“To improve maternal health outcomes, we must all work together to help ensure women are as healthy as they can be before becoming pregnant, and monitor them closely throughout their pregnancy and in the months after delivery,” says Ayers. 

Taking proactive steps to manage blood pressure before pregnancy can improve a woman’s chance of a healthy outcome for herself and her baby, adds Ayers. She suggests the following: 

• First and foremost, be sure to monitor your blood pressure. While a typical healthy blood pressure is around 120/80, talk with your doctor to determine a healthy baseline BP for you, and keep track to be sure you are on target. If not, you can work with your provider to develop a plan to manage your BP more effectively.
• Eat a healthy diet that includes fruits and vegetables and sets healthy limits on salt, fat and sugar.
• Get a good night’s sleep. Seven hours of sleep per night is a good target.
• Stay active. Speak with your doctor about safe ways to stay active and moving, generally for 20 or more minutes daily.
• Stay smoke free and try to avoid second-hand smoke.
• Get regular wellness visits and prenatal check-ups to monitor your health and discuss any concerns. 

High blood pressure, changes in your heart rate during pregnancy and delivery can add stress to your heart muscle. It is thus important to be aware of several signs that could potentially indicate a heart-related problem. If a pregnant woman or new mom is experiencing any of the following list of symptoms, she should discuss it with her doctor right away, Ayers says: chest pain; fainting, dizziness or lightheadedness; heart palpitations or rapid heart rate; persistent cough; severe shortness of breath; and significant swelling of the feet, ankles, hands and/or arms.

“Women are a vital part of their healthcare team,” stresses Ayers. “It’s important for them, and their loved ones, to feel empowered to speak up to their healthcare providers about their concerns, particularly if they feel that something ‘just isn’t right.’”

She also urges all obstetricians, obstetrical nurses and other health professionals involved in women’s health to remember the “Stop! Look! Listen!” mantra: “If your patient says she doesn’t feel well, or believes there is something wrong, Stop and don’t assume it’s a ‘typical’ new mother complaint. Look—that is, conduct an examination to be sure there are no evolving problems. And finally, Listen—hear the woman’s concerns and never consider them a usual part of having a baby.” 

The “Stop! Look! Listen!” maternal safety campaign is co-sponsored by Robert Wood Johnson Medical School and New Jersey Medical School, both part of Rutgers, The State University of New Jersey; Robert Wood Johnson University Hospital, an RWJBarnabas Health facility; and The Tara Hansen Foundation. It has been a vital part of the Maternal Health Awareness Day (MHAD) initiatives in New Jersey since its inception. 

First recognized in New Jersey as part of 2017 legislation to raise awareness of issues related to maternal health, the Jan. 23 commemoration of Maternal Health Awareness Day has since expanded to numerous states and gained national recognition from the American College of Obstetricians and Gynecologists, which this year will celebrate MHAD ’22 with the theme “Adding Up to Maternal Health,” highlighting the clinical approaches, policy solutions and partnerships that together can add up to improved maternal health across the United States.

For the 2022 celebration of Maternal Health Awareness Day in New Jersey, Robert Wood Johnson Medical School and New Jersey Medical School have joined with RWJBarnabas Health, the Tara Hansen Foundation, and the Central Jersey Family Health Consortium to develop a series of educational programs for healthcare professionals and the public, including a focus on hypertension during and immediately following pregnancy.

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