Racial/Ethnic, Nativity, and Sociodemographic Disparities in Maternal Hypertension in the United States, 2014-2015

This study examines racial/ethnic, nativity, and sociodemographic variations in the prevalence of maternal hypertension in the United States. The 2014-2015 national birth cohort data (N = 7,966,573) were modeled by logistic regression to derive unadjusted and adjusted differentials in maternal hypertension consisting of both pregnancy-related hypertension and chronic hypertension. Substantial racial/ethnic differences existed, with prevalence of maternal hypertension ranging from 2.2% for Chinese and 2.9% for Vietnamese women to 8.9% for American Indians/Alaska Natives (AIANs) and 9.8% for non-Hispanic blacks. Compared with Chinese women, women in all other ethnic groups had significantly higher risks of maternal hypertension, with Filipinos, non-Hispanic blacks, and AIANs showing 2.0 to 2.9 times higher adjusted odds. Immigrant women in most racial/ethnic groups had lower rates of maternal hypertension than the US-born, with prevalence ranging from 1.9% for Chinese immigrants to 10.3% for US-born blacks. Increasing maternal age, lower education, US-born status, nonmetropolitan residence, prepregnancy obesity, excess weight gain during pregnancy, and gestational diabetes were other important risk factors. AIANs, non-Hispanic whites, blacks, Puerto Ricans, and some Asian/Pacific Islander subgroups were at substantially higher risk of maternal hypertension. Ethnicity, nativity status, older maternal age, and prepregnancy obesity and excess weight gain should be included among the criteria used for screening for gestational hypertension.