(1002) Knowledge Gaps in Cardiovascular Maternal Mortality: A Regional Survey of Frontline Providers

Objective:
To evaluate knowledge, attitudes, and clinical practices of non-OB providers across ACOG District VII regarding cardiovascular-related (CV) maternal morbidity and mortality, with a focus on awareness, use of CV screening tools, and familiarity with national maternal safety initiatives (AIM).

Study Design:
A cross-sectional electronic survey was administered to 1,775 healthcare providers across eight states (AL, AR, KS, LA, MS, MO, OK, and TN). Of these, 610 providers met inclusion criteria and completed the survey. Respondents included physicians (65.9%), nurse practitioners (33.0%), and trainees (1.1%) specializing in family medicine, internal medicine, emergency medicine, and cardiology. The mean respondent age was 45.5 years, with an average of 13.9 years in clinical practice. The survey evaluated familiarity with the CDC definition of maternal mortality, use of validated CVD screening tools, awareness of AIM maternal safety bundles, and counseling practices related to CVD risk.

Results:
Only 39.3% of respondents correctly identified maternal mortality as death within 365 days postpartum. Less than half (43.9%) reported using a CVD screening tool during pregnancy, and only 20.8% were aware of the AIM safety bundles. A minority (23.3%) recognized postpartum as the time of greatest risk for maternal mortality. While most respondents correctly identified Black, uninsured, and low-income individuals as disproportionately affected, few were aware that American Indian/Alaska Native  have the highest and most rapidly rising mortality risk. Just over half (54.9%) acknowledged systemic discrimination as a contributing factor to maternal mortality, and 46.7% had ever completed formal education on the topic.

Conclusion:

Providers caring for pregnant and postpartum patients have a significant gap in knowledge regarding maternal mortality and limited awareness of CV risk assessment tools or ongoing national safety initiatives. There is an urgent need for targeted educational interventions and systems-level improvements for providers to improve their knowledge, and hopefully their care, for pregnant women.