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Hypertensive Disorders in Pregnancy and Mortality at Delivery Hospitalization - United States, 2017-2019

Nicole D Ford, Shanna Cox, Jean Y Ko

    MMWR. Morbidity and Mortality Weekly Report
    |April 28, 2022
    PubMed

    Insights

    Hypertensive disorders in pregnancy (HDPs) are increasingly common, affecting 15.9% of deliveries by 2019. Prompt identification and equitable treatment are crucial to prevent severe maternal complications and deaths.

    Area of Science:

    • Obstetrics and Gynecology
    • Public Health
    • Cardiovascular Medicine

    Background:

    • Hypertensive disorders in pregnancy (HDPs) are common and linked to severe maternal complications and mortality.
    • HDPs include chronic hypertension and pregnancy-associated hypertension.
    • These conditions are a leading cause of pregnancy-related deaths in the US.

    Purpose of the Study:

    • To analyze the prevalence of HDPs among delivery hospitalizations in the US from 2017-2019.
    • To examine HDP prevalence by maternal characteristics and geographic regions.
    • To determine the percentage of in-hospital deaths associated with HDP.

    Main Methods:

    • Analysis of nationally representative data from the National Inpatient Sample (2017-2019).
    • Calculation of annual prevalence of HDPs and specific types (pregnancy-associated, chronic).
    • Examination of HDP prevalence across demographic groups and hospital locations.

    Main Results:

    • Overall HDP prevalence increased from 13.3% to 15.9% between 2017 and 2019.
    • Pregnancy-associated hypertension rose from 10.8% to 13.0%; chronic hypertension from 2.0% to 2.3%.
    • Highest HDP prevalence observed in Black, AI/AN women, older mothers, low-income areas, and the South/Midwest regions. 31.6% of delivery-related deaths had documented HDP.

    Conclusions:

    • HDPs represent a growing public health concern in US pregnancies.
    • Disparities in HDP prevalence highlight the need for targeted interventions.
    • Equitable implementation of monitoring and timely treatment strategies can reduce severe HDP complications and mortality.

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