Race alone does not account for higher preeclampsia rates for Black women, study finds

A pregnant woman and her partner
Written by Publishing Team

A new analysis of the medical records of a racially diverse group of more than 6,000 women has added to the evidence that a combination of biological, social and cultural factors – not race alone – is likely responsible for the higher rates of preeclampsia among black women born in the United States compared to black women who immigrated to the country.

Data on preeclampsia, a severe form of high blood pressure that can lead to fatal consequences for both mother and fetus, was collected over a 28-year period as part of the Boston Birth Cohort study originally designed to study the factors genetic and environmental associated with premature births. Preeclampsia is one of the leading causes of maternal death worldwide, with black women being three to four times more likely to die from pregnancy-related causes than white women, according to the US Centers for Disease Control and Prevention. United. Preeclampsia affects about 1 in 25 pregnancies in the United States, and those who do have an increased risk of developing chronic hypertension and cardiovascular disease later in life.

The study was published on December 20 in the Journal of the American Medical Association. The new analysis, led by researchers at Johns Hopkins Medicine, specifically looked at differences in hypertension and other risk factors for cardiovascular disease and the prevalence of preeclampsia in Hispanic, black and white women. The results showed that the three groups of women who gave birth and were born in the United States had a higher cardiovascular disease risk profile than their foreign-born counterparts after accounting for differences in weight, smoking, alcohol consumption, stress and diabetes.

For black women, birth status outside the United States and a shorter length of residence (those who lived in America for less than 10 years) were associated with a 26% lower likelihood of preeclampsia. Birthplace status and length of residence in the United States were not significantly associated with the risk of preeclampsia in Hispanic and white mothers born outside the United States

Overall, the researchers said, the findings suggest that birthplace disparities, or “nativity,” in preeclampsia in black women are “not fully explained” by differences in nativity in socio-demographic factors. or cardiovascular disease.

“Immigrants come here to seek a better life, but what we are seeing is unhealthy acculturation and assimilation,” says lead researcher Garima Sharma, director of cardio-obstetrics at Johns University School of Medicine. Hopkins.

“Some women come here healthier and become increasingly unhealthy over time, possibly adopting mainstream culture habits that increase poor health outcomes. Although we did not specifically examine the impact of structural racism on health in this study, it may also play a role Black women who were born outside the United States but immigrated to the country recently can be anything. little protected from the effects of discrimination, as they tend to settle in residential areas with a high concentration of immigrants with increased social support, ”added Sharma.

Sharma pointed out that more research is needed to explore the interplay of biological, psychosocial and social determinants of health contributing to pregnancy-related disparities in preeclampsia. For years, being a black woman has been said to be a risk factor for preeclampsia, Sharma said, but “we have to get past all the implications on a particular race without explaining why, because in this study, it’s clear that black women born outside of the United States are less likely to have preeclampsia until they’ve been here for some time. “

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