COLORADO SPRINGS — According to a CDC report, hypertensive disorders in pregnancy (HDP) among women have increased from about 13% to 16% since 2017. This means at least one in seven delivery hospitalizations are affected by HDP.
HDP is the leading cause of pregnancy-related deaths in the United States. It can cause complications such as heart attacks and strokes for pregnant women. HPD includes pregnancy-associated hypertension that begins before, during or after pregnancy.
In a press release by the CDC, Janet Wright, M.D., F.A.C.C., director of CDC’s Division of Heart Disease and Stroke Prevention, said there are many strategies clinicians can use to identify, monitor and manage individuals with hypertensive disorders. Wright works for the National Center for Chronic Disease Prevention and Health Promotion.
“A great example is home-monitoring of blood pressure during and following pregnancy,” she said. “At a systems level, intentional programming like Perinatal Quality Collaboratives can improve the quality of care and health outcomes and translate findings into interventions.”
To explain the increase in HDP prevalence, the CDC report cites advanced maternal age and the increase of obesity rates and diabetes as characteristics associated with high risk women.
Apparent racial and ethnic disparities of HDP among hospital deliveries put minorities at higher risk, according to the CDC. They say HDP affects more than 1 in 5 delivery hospitalizations of African American women and about 1 in 6 delivery hospitalizations of American Indian and Alaska Native women.
The CDC contributes differences in access to and quality of healthcare to these racial and ethnic inequities. And, they say, minorities experience a higher prevalence of characteristics associated with HDP. Per this recent report, racial bias in the U.S. healthcare system also affects how HDP is screened, diagnosed and treated. Additionally, it states, psychosocial stress from experiencing racism has also been found to be associated with chronic hypertension.
“As healthcare professionals, we must recognize the factors that contribute to racial inequities and work individually and collectively to reduce these rates,” said Wanda Barfield, M.D., M.P.H., director of CDC’s Division of Reproductive Health. “Addressing hypertensive disorders in pregnancy is a key strategy in reducing inequities in pregnancy-related mortality.”
The CDC’s report shows the highest prevalence of HDP is found among women over the age of 45 at 31%. It was also high among those who reside in rural counties at 16% and those living in lower income ZIP codes at 16%. Hospital deliveries in the South and Midwest experienced the highest cases of HDP. Varying levels and types of HDP contributors such as diet, tobacco use, physical activity patterns, level of poverty, or access to healthcare can explain these disparities based on location.
The CDC reported that strengthening regional networks of health care facilities, providing risk-appropriate maternal care through telemedicine, and the ability to transfer those with high-risk conditions to facilities are strategies to reduce such disparities.
To prevent HDP complications and deaths, the CDC aims to implement public health and clinical strategies that increase awareness of urgent maternal warning signs and quality improvement initiatives to address hypertension.
For additional resources and information check the links below:
- High blood pressure during pregnancy
- Preventing Pregnancy-Related Deaths
- CDC’s Hear Her campaign, which raises awareness of urgent maternal warning signs.