TOPLINE

Hypertensive disorders of pregnancy increased by about 7% each year on average in the US from 2016 to 2024, rising from 62.7 to 109.1 per 1000 live births. Non-Hispanic American Indian or Alaska Native (AIAN) individuals had the highest absolute rates by 2024, followed by non-Hispanic Black individuals.

METHODOLOGY

• Researchers conducted a cross-sectional study to evaluate temporal patterns in the prevalence of hypertensive disorders of pregnancy among individuals with live births in the US.
• They analyzed natality data from the National Vital Statistics System including all US live births between 2016 and 2024; over 33.36 million live births were included in the analysis.
• Birth certificate records indicating gestational hypertension, eclampsia, or preeclampsia were used to ascertain hypertensive disorders of pregnancy.
• Prevalence rates were computed per 1000 live births, age-standardized based on the 2016 age distribution, while joinpoint regression analysis identified significant changes in temporal trends.
• Participants reported their own race and ethnicity, which were categorized into: non-Hispanic White, non-Hispanic Black, non-Hispanic Asian, non-Hispanic AIAN, non-Hispanic Native Hawaiian or Other Pacific Islander, Hispanic, multiracial, and unknown or unstated.

TAKEAWAY

• From 2016 to 2024, the age-standardized prevalence of hypertensive disorders of pregnancy per 1000 live births rose from 62.7 (95% CI, 62.4-62.9) to 109.1 (95% CI, 108.7-109.4), reflecting an average annual percent change (AAPC) of 7.2% (P < .001).
• In 2021, a significant inflection point was detected, characterized by a steeper increase of 8.9% annually during 2016-2021 and then a slower increase of 4.4% during 2021-2024.
• AAPCs were the greatest among non-Hispanic Asian and multiracial individuals at 9.7% (95% CI, 9.1-10.3) and 7.9% (95% CI, 7.6-8.3), respectively.
• Peak absolute prevalence in 2024 per 1000 live births was noted among non-Hispanic AIAN individuals at 143.7 (95% CI, 139.1-148.3) and non-Hispanic Black individuals at 132.7 (95% CI, 131.7-133.7), and subsequently among non-Hispanic White individuals at 119.2 (95% CI, 118.7-119.7).

IN PRACTICE

"Continued surveillance and targeted prevention strategies are needed to address the rising burden of HDP [hypertensive disorders of pregnancy] and persistent disparities," the researchers wrote.

SOURCE

The study was led by Ronald Anguzu, PhD, of the Institute for Health and Humanity at the Medical College of Wisconsin in Milwaukee. It was published online on October 6 as a research letter in Obstetrics & Gynecology.

LIMITATIONS

Birth certificate data may contain misclassification, missing information, and residual confounding, including the inability to distinguish superimposed preeclampsia and hemolysis, elevated liver enzymes, and low platelet count syndrome. The study only analyzed live births; hence, the complete burden of hypertensive disorders of pregnancy on stillbirths or fetal deaths was not captured.

DISCLOSURES

The study was supported by grants from the Eunice Kennedy Shriver National Institute of Child Health and Human Development. The authors reported no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.