Hypertensive disorders in pregnancy vary widely by state, study finds
Sept. 30 (UPI) — Alaska, Hawaii, Louisiana and Missouri are among the states with the highest prevalence of hypertensive pregnancy disorders, according to an analysis published Thursday by JAMA Network Open.
Just over 9% of all mothers in Louisiana developed chronic hypertension after giving birth in 2017, the highest percentage of any of the 50 states, the data showed.
Nearly 3% of women who gave birth in Hawaii that same year suffered from eclampsia — seizures during pregnancy caused by high blood pressure.
Alaska, Louisiana and Missouri also were among the leaders in the prevalence of chronic high blood pressure among pregnant women, according to the researchers.
“We believe it’s good for the public to see the prevalence of these disorders, by state, so that they can have a full understanding of their risk,” study co-author Dr. Alexander Butwick told UPI.
“Now, future studies need to look at why the prevalence is so high in some states,” said Butwick, associate professor of anesthesiology, perioperative and pain medicine at Stanford University.
Hypertensive disorders of pregnancy occur in up to 10% of pregnant women in the United States and increase the risk for birth complications for both mother and child as well as the risk for heart disease for the mother later in life, research says.
The disorders include chronic high blood pressure that develops as a result of pregnancy, pre-eclampsia and eclampsia.
Pre-eclampsia also can include liver or kidney damage that occurs as a result of high blood pressure that develops during pregnancy.
About 4% of mothers develop pre-eclampsia, and it progresses to eclampsia in about one in four of these women — or 1% of all pregnant women — according to the U.S. Centers for Disease Control and Prevention.
For their research, Butwick and his colleagues reviewed data on nearly 3.7 million women who had live births in 2017. Just over 57% of the women were 25 to 34 years old at the time of their pregnancy, the researchers said.
Among the women included in the analysis, just under 2% had chronic high blood pressure before getting pregnant, and 6% were diagnosed with hypertensive disorders of pregnancy, the data showed.
Louisiana, at 9.3%; New Hampshire, 8.9%; Alaska, 8.8%; Ohio, 8%; and Oregon, 7.8%, had the highest prevalence of the disorders, while Massachusetts had the lowest, at 4.3%, researchers said.
Hawaii, at 2.8%; Alaska, 1.8%; Virginia, 1.6%; and Alabama, 1.5%, had the highest percentages of pregnant women who developed eclampsia nationally, while Delaware, Idaho, Utah, Texas and New Hampshire were among the lowest at less than 0.1% each.
Although their study did not explore why the prevalence of these hypertensive disorders varies by state, Butwick and his colleagues believe that differences in the overall health of expecting mothers and the health services available to them could play a significant part.
The researchers expect the findings will help start conversations between pregnant women and their care teams, they said.
“If I am a [pregnant woman] in Hawaii, for example, and I see that the prevalence of eclampsia is much higher than 1% [the national average], and I know that I have high blood pressure already, I am going to ask my OBGYN what their plan is to help me avoid developing eclampsia,” Butwick said.