Nativity-Related Disparities in Preeclampsia and Cardiovascular Disease Risk Among a Racially Diverse Cohort of US Women

Boakye, Ellen; Kwapong, Yaa A; Obisesan, Olufunmilayo H.; Ogunwole, S. Michelle; Hays, Allison G.; Nasir, Khurram; Blumenthal, Roger S.; Douglas, Pamela S.; Blaha, Michael J.; Hong, Xiumei; Creanga, Andreea A.; Wang, Xiaobin; Sharma, Garima

doi:10.1001/jamanetworkopen.2021.39564

Cited by 36 publications

(46 citation statements)

References 51 publications

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“…Figure 1 provides a visual overview of the PE risk among different non-White populations compared to non-Hispanic White women reported in these studies. The prevalence of PE was significantly higher among non-Hispanic Black, Black, and African American women compared to non-Hispanic White or White women in the US in most studies (adjusted OR 1.2–2.3), ranging from 2.5 to 8.3% ( 29 , 36 , 42 , 45 , 49 , 55 , 56 , 60 , 63 , 65 , 67 , 72 , 73 , 75 ). In one high-risk cohort, oversampled with women who delivered preterm, a higher PE prevalence was found among non-Hispanic Black women (9.2–12.2%), but PE prevalence among non-Hispanic White women was similarly increased, so that the relative risk for non-Hispanic Black women was comparable to the other studies ( 75 ).…”

Section: Hypertensive Disorders Of Pregnancy Across Racial and Ethnic...mentioning

confidence: 95%

“…The prevalence of PE was significantly higher among non-Hispanic Black, Black, and African American women compared to non-Hispanic White or White women in the US in most studies (adjusted OR 1.2–2.3), ranging from 2.5 to 8.3% ( 29 , 36 , 42 , 45 , 49 , 55 , 56 , 60 , 63 , 65 , 67 , 72 , 73 , 75 ). In one high-risk cohort, oversampled with women who delivered preterm, a higher PE prevalence was found among non-Hispanic Black women (9.2–12.2%), but PE prevalence among non-Hispanic White women was similarly increased, so that the relative risk for non-Hispanic Black women was comparable to the other studies ( 75 ). One study reported higher PE prevalence among US-born non-Hispanic Black women than among foreign-born non-Hispanic Black women, although after 10 years of residence in the US, the difference was no longer statistically significant ( 75 ).…”

Section: Hypertensive Disorders Of Pregnancy Across Racial and Ethnic...mentioning

confidence: 95%

“…The prevalence of chronic hypertension in most Latina/Hispanic groups was similar to, or lower than in non-Hispanic Black and non-Hispanic White women. One study reported lower rates of chronic hypertension among foreign-born compared to US-born Latina or Hispanic women in the US, except in Puerto Rican women; a second study reported no significant difference ( 43 , 75 ).…”

Section: Hypertensive Disorders Of Pregnancy Across Racial and Ethnic...mentioning

confidence: 99%

Section: Hypertensive Disorders Of Pregnancy Across Racial and Ethnic...mentioning

confidence: 99%

“…Sixteen studies reported on the prevalence of chronic hypertension ( Supplementary Table 5 ) ( 36 , 38 , 40 , 42 , 43 , 45 , 47 – 49 , 51 , 61 , 67 , 71 , 72 , 75 , 78 ). Eleven of these studies reported on the prevalence of chronic hypertension among non-Hispanic Black, Black, or African American women in the US ( 36 , 40 , 42 , 43 , 45 , 49 , 67 , 71 , 72 , 75 , 78 ). In most studies, the prevalence of chronic hypertension in these women ranged between 0.8 and 3.3% and was 1.4–2.3-fold higher than among non-Hispanic White women ( 36 , 40 , 43 , 45 , 49 , 67 , 71 , 72 , 78 ).…”

Section: Hypertensive Disorders Of Pregnancy Across Racial and Ethnic...mentioning

confidence: 99%

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Hypertensive Disorders of Pregnancy and Cardiovascular Disease Risk Across Races and Ethnicities: A Review

Burger

Delagrange

Valkengoed

et al. 2022

Front. Cardiovasc. Med.

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Pregnancy is often considered to be a “cardiometabolic stress-test” and pregnancy complications including hypertensive disorders of pregnancy can be the first indicator of increased risk of future cardiovascular disease. Over the last two decades, more evidence on the association between hypertensive disorders of pregnancy and cardiovascular disease has become available. However, despite the importance of addressing existing racial and ethnic differences in the incidence of cardiovascular disease, most research on the role of hypertensive disorders of pregnancy is conducted in white majority populations. The fragmented knowledge prohibits evidence-based targeted prevention and intervention strategies in multi-ethnic populations and maintains the gap in health outcomes. In this review, we present an overview of the evidence on racial and ethnic differences in the occurrence of hypertensive disorders of pregnancy, as well as evidence on the association of hypertensive disorders of pregnancy with cardiovascular risk factors and cardiovascular disease across different non-White populations, aiming to advance equity in medicine.

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Section: Hypertensive Disorders Of Pregnancy Across Racial and Ethnic...mentioning

confidence: 95%

Section: Hypertensive Disorders Of Pregnancy Across Racial and Ethnic...mentioning

confidence: 95%

Section: Hypertensive Disorders Of Pregnancy Across Racial and Ethnic...mentioning

confidence: 99%

Section: Hypertensive Disorders Of Pregnancy Across Racial and Ethnic...mentioning

confidence: 99%

Section: Hypertensive Disorders Of Pregnancy Across Racial and Ethnic...mentioning

confidence: 99%

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Hypertensive Disorders of Pregnancy and Cardiovascular Disease Risk Across Races and Ethnicities: A Review

Burger

Delagrange

Valkengoed

et al. 2022

Front. Cardiovasc. Med.

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The Intersection of Nativity With Race and Ethnicity in Preeclampsia—Broadening the Assessment of Social Determinants of Maternal Health

2021

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There are approximately 4 million births annually in the US, and approximately 1 in 5 of these births are complicated by 1 or more interrelated adverse pregnancy outcomes (APOs), including preeclampsia, preterm delivery, and birth of an infant who is small for their gestational age. 1 APOs are increasing in incidence, have shared upstream risk factors, and have important health implications for both the birthing person and offspring. Numerous studies have demonstrated the associations between APOs and increased risk for maternal and neonatal morbidity and mortality. The pathophysiologic processes leading to APOs begin before conception and are, in part, associated with maternal cardiovascular risk factors (eg, obesity, hypertension) present before pregnancy. 2 Evolving evidence implicates social, structural, and systemic factors as upstream determinants of health associated with the significant and pervasive racial and ethnic disparities in maternal health outcomes, with higher rates of prepregnancy cardiovascular risk factors, APOs, and postpartum cardiovascular disease (CVD) in non-Hispanic Black individuals compared with non-Hispanic White individuals. Such factors include adverse life events and stressors, socioeconomic status at the individual and neighborhood level, and experiences of racism and discrimination. Beyond these

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Maternal Nativity and Preterm Birth

Huang,

Lee,

Wang

et al. 2024

JAMA Pediatr

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ImportancePreterm birth is a major contributor to neonatal morbidity and mortality, and considerable differences exist in rates of preterm birth among maternal racial and ethnic groups. Emerging evidence suggests pregnant individuals born outside the US have fewer obstetric complications than those born in the US, but the intersection of maternal nativity with race and ethnicity for preterm birth is not well studied.ObjectiveTo determine if there is an association between maternal nativity and preterm birth rates among nulliparous individuals, and whether that association differs by self-reported race and ethnicity of the pregnant individual.Design, Setting, and ParticipantsThis was a nationwide, cross-sectional study conducted using National Center for Health Statistics birth registration records for 8 590 988 nulliparous individuals aged 15 to 44 years with singleton live births in the US from 2014 to 2019. Data were analyzed from March to May 2022.ExposuresMaternal nativity (non–US-born compared with US-born individuals as the reference, wherein US-born was defined as born within 1 of the 50 US states or Washington, DC) in the overall sample and stratified by self-reported ethnicity and race, including non-Hispanic Asian and disaggregated Asian subgroups (Asian Indian, Chinese, Filipino, Japanese, Korean, Pacific Islander, Vietnamese, and other Asian), non-Hispanic Black, Hispanic and disaggregated Hispanic subgroups (Cuban, Mexican, Puerto Rican, and other Hispanic), and non-Hispanic White.Main Outcomes and MeasuresThe primary outcome was preterm birth (&lt;37 weeks of gestation) and the secondary outcome was very preterm birth (&lt;32 weeks of gestation).ResultsOf 8 590 988 pregnant individuals included (mean [SD] age at delivery, 28.3 [5.8] years in non–US-born individuals and 26.2 [5.7] years in US-born individuals; 159 497 [2.3%] US-born and 552 938 [31.2%] non–US-born individuals self-identified as Asian or Pacific Islander, 1 050 367 [15.4%] US-born and 178 898 [10.1%] non–US-born individuals were non-Hispanic Black, 1 100 337 [16.1%] US-born and 711 699 [40.2%] non–US-born individuals were of Hispanic origin, and 4 512 294 [66.1%] US-born and 328 205 [18.5%] non–US-born individuals were non-Hispanic White), age-standardized rates of preterm birth were lower among non–US-born individuals compared with US-born individuals (10.2%; 95% CI, 10.2-10.3 vs 10.9%; 95% CI, 10.9-11.0) with an adjusted odds ratio (aOR) of 0.90 (95% CI, 0.89-0.90). The greatest relative difference was observed among Japanese individuals (aOR, 0.69; 95% CI, 0.60-0.79) and non-Hispanic Black individuals (aOR, 0.74; 0.73-0.76) individuals. Non–US-born Pacific Islander individuals experienced higher preterm birth rates compared with US-born Pacific Islander individuals (aOR, 1.15; 95% CI, 1.04-1.27). Puerto Rican individuals born in Puerto Rico compared with those born in US states or Washington, DC, also had higher preterm birth rates (aOR, 1.07; 95% CI, 1.03-1.12).Conclusions and RelevanceOverall preterm birth rates were lower among non–US-born individuals compared with US-born individuals. However, there was substantial heterogeneity in preterm birth rates across maternal racial and ethnic groups, particularly among disaggregated Asian and Hispanic subgroups.

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Nativity-Related Disparities in Preeclampsia and Cardiovascular Disease Risk Among a Racially Diverse Cohort of US Women

Cited by 36 publications

References 51 publications

Hypertensive Disorders of Pregnancy and Cardiovascular Disease Risk Across Races and Ethnicities: A Review

Hypertensive Disorders of Pregnancy and Cardiovascular Disease Risk Across Races and Ethnicities: A Review

The Intersection of Nativity With Race and Ethnicity in Preeclampsia—Broadening the Assessment of Social Determinants of Maternal Health

Maternal Nativity and Preterm Birth

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