Neonatal Outcomes of Hypertensive Women Across US Races: 2016-2022
Abstract Body (Do not enter title and authors here): Background: Maternal hypertension, a major pregnancy complication, can adversely affect newborn health. We aim to evaluate the racial and ethnic disparities in neonatal outcomes among hypertensive pregnant women in the United States. Methods: Using data from the CDC WONDER Natality database, we conducted a retrospective cohort study focusing on live births to hypertensive mothers from 2016 to 2022. Neonatal outcomes, including NICU admissions, low birth weight, infant mortality, and assisted ventilation, were analyzed by calculating rates [95% CIs] per 1000 live births across maternal racial/ethnic groups and the US Census Bureau's regional classification: Northeast, Midwest, South, and West. Results: We analyzed 2,336,679 live births to hypertensive women (23% pre-pregnancy; 77% gestational). This cohort comprised: 0.2% infants born to Native Hawaiian/other Pacific Islander women (NH/PI), 0.9% to American Indian/Alaska Native women (AI/AN), 3.8% to Asian American women (AA), 19.6% to Hispanic/Latino women (H/L), 20.0% to Black/African American women (BA), and 55.4% to White American women (WA). Infant mortality rates were highest in BA (3.6 [3.5, 3.8]), followed by AA (2.1 [1.8, 2.4]), AI/AN (2.1 [1.6, 2.7]), H/L (1.9 [1.8, 2.0]), NH/PI (1.9 [1.0, 3.3]), and lowest in WA (1.5 [1.4, 1.6]). Similarly, NICU admission rates were highest in BA (217.2 [216.1, 218.4]) and lowest in WA (156 [155.4, 156.6]). Assisted ventilation rates were highest in NH/PI (131.8 [123.4, 140.7]) and lowest in AA (87.8 [86.0, 89.7]). Low birth weight rates were highest in BA (235.1 [233.9, 236.3]) and lowest in WA (121.8 [121.2, 122.4]). The Midwest had the highest rates for NICU admissions in NH/PI (254.2 [217.2, 295.2]), assisted ventilation in AI/AN (143.8 [133.2, 155.1]), and mortality in BA (4.1 [3.7, 4.5]). The South had the highest rate of low birth weight for BA (244.4 [242.9, 246.0]). Conclusion: Significant racial and regional disparities exist in neonatal outcomes among hypertensive women in the US. BA mothers consistently experienced the poorest outcomes, while WA mothers had the best. Further research is crucial to understand the reasons behind these disparities and develop targeted interventions for high-risk populations.
Usman, Muhammad Shariq
( University of Texas Southwestern Medical Center
, Dallas
, Texas
, United States
)
Khan, Ayesha Ali
( Nishtar Medical University
, Karachi
, Pakistan
)
Afzal, Ahson
( Dow Medical College
, Karachi
, Pakistan
)
Siddiqi, Tariq Jamal
( University of Mississippi Medical Center
, Ridgeland
, Mississippi
, United States
)
Hall, Michael And Jo Alice
( UNIV OF MISSISSIPPI MEDICAL CENTER
, Jackson
, Mississippi
, United States
)
Salman, Ali
( Dow Medical College
, Karachi
, Pakistan
)
Khan, Muhammad
( Dow International Medical College
, Karachi
, Pakistan
)
Aisha, Eliza
( Dow Medical College
, Karachi
, Pakistan
)
Naz, Sabina
( University Hospitals of Morecambe Bay NHS Foundation Trust
, Kendal
, United Kingdom
)
Faisal, Sarah
( Jinnah Sindh Medical University
, Karachi
, Pakistan
)
Khan, Iqra
( King Edward Medical University
, Lahore
, Pakistan
)
Arif, Muhammad Hammad
( DG Khan Medical College
, Karachi
, Pakistan
)
Janjua, Hamza
( Rhodes College
, Memphis
, Tennessee
, United States
)
Author Disclosures:
Muhammad Shariq Usman:No Answer
| Ayesha Ali Khan:DO NOT have relevant financial relationships
| Ahson Afzal:No Answer
| Tariq Jamal Siddiqi:DO NOT have relevant financial relationships
| Michael and Jo Alice Hall:DO NOT have relevant financial relationships
| Ali Salman:DO NOT have relevant financial relationships
| Muhammad Khan:DO NOT have relevant financial relationships
| Eliza Aisha:DO NOT have relevant financial relationships
| Sabina Naz:No Answer
| Sarah Faisal:No Answer
| Iqra Khan:No Answer
| Muhammad Hammad Arif:DO NOT have relevant financial relationships
| Hamza Janjua:DO NOT have relevant financial relationships
