Takeaway
- The prevalence of chronic hypertension in pregnancy has increased more than 13-fold in the last 40 years, even as racial disparities persisted through that period.
- Older maternal age is one reason for the increase, but some other candidate factors are modifiable.
Why this matters
- Women are delaying pregnancy and childbirth because of social forces, but lifestyle-related factors involved in hypertension of pregnancy need emphasis.
- These include maintaining a healthy nonpregnant weight and BP, not smoking, and taking preventive measures against type 2 diabetes.
- Race disparities also need focus.
Key results
- Rate of chronic hypertension during pregnancy increased by about 6% each year during the study period, more so for white women (7%; 95% CI, 6%-7%) than black women (4%; 95% CI, 3%-4%).
- However, although the prevalence of chronic hypertension in pregnancy was 0.63% overall, it was 1.24% among black women vs 0.53% among white women:
- Rate ratio: 2.31 (95% CI, 2.30-2.32).
- Age was associated with increased rate of chronic hypertension during pregnancy.
Study design
- Population-based cross-sectional study, 151 million women who delivered in a US hospital, 1970-2010.
- Funding: None.
Limitations
- Diagnostic criteria changes might explain some of the increase.
- Potential inaccuracies in data recording.
- Trends in antihypertensive treatment not known.
References
References