Hypertension, Anemia Contribute to Racial Disparities in Severe Maternal Morbidity

FRIDAY, Sept. 8, 2023 (HealthDay News) -- Hypertension and anemia contribute to racial disparities in severe maternal morbidity (SMM), according to two studies published online Sept. 7 in Obstetrics & Gynecology.

Stephanie A. Leonard, Ph.D., from Stanford University in California, and colleagues conducted a population-based study to examine the associations between chronic hypertension and several obstetric and neonatal outcomes. Data were included from 7,955,713 pregnancies, of which 2.1 percent were complicated by chronic hypertension. The researchers found that chronic hypertension was associated with adverse obstetric and neonatal outcomes, with the largest population attributable risks (PARs) seen for preeclampsia with severe features or eclampsia, acute renal failure, and pulmonary edema (22.4, 13.6, and 10.7, respectively). The adjusted PAR percentages for SMM were 5.0, 3.7, 9.0, 3.9, 11.6, 3.2, and 5.5 for American Indian-Alaska Native, Asian, Black, Latino, Native Hawaiian-Pacific Islander, White, and Multiracial-Other, respectively.

Irogue Igbinosa, M.D., from Stanford University in California, and colleagues examined the contribution of antepartum anemia to SMM using data from 3,863,594 births in California from 2011 through 2020. The researchers found that the incidence of antepartum anemia was highest among Black patients followed by Pacific Islander patients (21.5 and 18.2, respectively); incidence was lowest for White pregnant patients (9.6 percent). The PAR percentage for antepartum anemia and SMM was highest for multiracial, Black, and Hispanic patients within each racial and ethnic group (21.4, 20.9, and 20.9 percent, respectively).

"The more evidence we use to standardize our approach to prenatal care, the more we can address and dismantle the effects of implicit bias on health care delivery," Igbinosa said in a statement.

One author from the Leonard study disclosed payment as an expert witness; one author from the Igbinosa study disclosed ties to industry.

Abstract/Full Text - Leonard

Abstract/Full Text - Igbinosa