A study published today in the Journal of the American Heart Association reveals substantial disparities in pregnancy-related high blood pressure risk among Asian American, Native Hawaiian and Pacific Islander populations. Analyzing California health records from 2007 to 2019, researchers found that Pacific Islander and Filipino individuals had two to three times higher risk of hypertensive disorders of pregnancy compared to Chinese individuals, after adjusting for sociodemographic and maternal health factors.
Pregnancy-related high blood pressure, which includes conditions such as chronic hypertension, gestational hypertension, preeclampsia, eclampsia, and chronic hypertension with preeclampsia, affects about 1 in 7 pregnancies in the United States and is a leading cause of maternal illness and death. The study included 772,688 pregnant individuals who self-identified as Asian American, Native Hawaiian or Pacific Islander, divided into 15 subgroups. The lowest frequency of these conditions was found in the Chinese subgroup at 3.7%, while the Guamanian subgroup had the highest at 13%.
“There are known ways to help prevent and treat high blood pressure during pregnancy. Our findings can help health care professionals identify those who are at higher risk,” said study lead author Jennifer Soh, M.S., who conducted the research as a master’s student at Stanford University School of Medicine. Early identification and treatment can prevent serious complications for both the pregnant individual and their infant, she noted.
The study found that only Japanese, Korean and Vietnamese individuals had risks not elevated compared to the Chinese reference group. The researchers adjusted for factors such as age, socioeconomic status, and pre-existing health conditions. The observed differences highlight the variation in lived experiences and underscore the need for future studies to examine structural and social factors that may explain the elevated risks.
The study had limitations, including reliance on medical diagnostic codes, which may be subject to underreporting or misclassification, and data only from California, which may not generalize to other communities. Additionally, the study could not account for the effects of the COVID-19 pandemic or factors such as air pollution, neighborhood walkability, and food access.
“Future studies should examine more structural and social factors that could help explain the differences in the elevated risks found in this study,” Soh said. The findings are published in the Journal of the American Heart Association, an open access, peer-reviewed journal. More information about pregnancy and maternal health can be found on the American Heart Association website.
The American Heart Association emphasizes that hypertensive disorders of pregnancy can be managed with medication or lifestyle changes. The organization also notes that personalized screening early in pregnancy may improve preeclampsia detection, as highlighted in a 2024 news release.
