A new scientific statement from the American Heart Association, published today in the journal Circulation, highlights the critical need for early detection and timely treatment of heart failure in pregnant and postpartum women to prevent serious complications, including irregular heartbeat, stroke, and death.
Heart failure affects nearly 1 in 4 women aged 20-44, according to a 2026 American Heart Association scientific statement on forecasting cardiovascular disease in women. Data from the U.S. Centers for Disease Control and Prevention indicate that heart disease is now one of the leading causes of pregnancy-related death in the U.S.
“Heart failure during and after pregnancy is often hiding in plain sight,” said Dr. Demilade A. Adedinsewo, chair of the statement writing group. Symptoms such as shortness of breath, fatigue, and swelling are common in healthy pregnancies, leading to underrecognition. Peripartum cardiomyopathy, a form of heart muscle failure, can develop late in pregnancy or months after delivery.
Risk factors include high blood pressure, diabetes, obesity, and older maternal age. Black and Native American women face higher risks and are more likely to be diagnosed later. Data show that Black adults have about a 19% higher risk of developing heart failure than white adults. Among American Indian/Alaska Native women, heart failure contributed to 14.5% of pregnancy-related deaths.
Delays in diagnosis can be life-threatening. Pregnant women with heart failure are about 32 times more likely to die around delivery compared to those without heart failure. Other risks include stroke, preterm birth, and poor fetal outcomes.
Diagnostic tools such as electrocardiograms, blood tests, and echocardiograms can distinguish normal pregnancy changes from heart failure. Treatment includes medications like beta blockers and diuretics, and a multidisciplinary cardio-obstetrics team is critical for optimal care.
The postpartum period, especially the first year after delivery, is a high-risk time. The statement emphasizes the need for continued monitoring beyond the traditional six-week visit, including telemedicine and digital technologies. Contraception counseling is also important, with hormonal intrauterine devices preferred for women with heart failure.
“Improving postpartum care is essential to protecting maternal health,” Adedinsewo said. The statement calls for standardized screening, listening to patient concerns, and improved access to care to help improve outcomes.
For more information, view the full statement at Circulation. Additional resources include the American Heart Association’s heart failure information and the Maternal Health Initiative.
