Data Analysis Indicates Preeclampsia Risk

According to a data analysis of medical records for a racially diverse group of over 6,000 women, there is evidence that a combination of biological, social, and cultural factors are responsible for higher rates of preeclampsia among Black women born in the United States compared to Black women who immigrated to the county.

The data on preeclampsia was gathered over 28 years as part of the Boston Birth Cohort study created to investigate the genetic and environmental factors linked to premature births.

The new data analysis, led by Johns Hopkins Medicine researchers, examined differences in hypertension and other cardiovascular disease risk factors among Hispanic, Black, and White populations.

The results indicated that all three groups of women who gave birth and were born in the US had a higher cardiovascular disease risk profile than those born outside the US.  

For black women, birth status outside the US and shorter duration of residence were associated with 26 percent lower odds of preeclampsia. According to the research team, however, the findings that suggest that place of birth is related to disparities in preeclampsia are not fully explained.

“Immigrants come here to seek a better life, but what we are seeing is unhealthy acculturation and assimilation. Some women come here healthier and they get unhealthier over time probably by adopting habits of the dominant culture that increase poor health outcomes,” lead researcher Garima Sharma said in a press release.

“While we didn’t specifically look at the impact of structural racism on health in this study, it may also play a role here. “Black women who were born outside the U.S. but immigrated to the country recently may be somewhat protected from the effects of discrimination because they tend to settle in immigrant-concentrated residential areas with increased social support.”

In the study, medical records and data totaling 6,069 women were analyzed. The average age of the participants was 27.5 years and the subjects self-identified as Hispanic (2,400, with 76.8% born outside the US), Black (2,699, with 40.5% born outside the US), or White (997, with 22.2% born outside the US).

Every woman had a single-child delivery at the Boston Medical Center from October 1998 to February 2016. The overall prevalence of preeclampsia among the group was 9.5 percent. Black women had the highest age-adjusted prevalence of preeclampsia (12.4%) compared with Hispanic (8.2%) and White women (7.1%).

According to Sharma, “although not explored in this study, the stress of systemic racism, living in racially segregated neighborhoods and experiences of discrimination are likely contributors to the poor health of Black women and may therefore contribute to disparities in cardiovascular risk factors and preeclampsia,” the press release stated.

Additionally, the lack of access to health care services and poor quality of care are also factors impacting those at lower socioeconomic levels.

Preeclampsia is one of the leading causes of maternal deaths worldwide, with Black women being disproportionately impacted. Preeclampsia affects about 1 in 25 pregnancies in the US, and those who experience it have an increased risk of developing chronic hypertension and cardiovascular disease later in life.