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Racial and Socioeconomic Disparities in Cardiovascular Outcomes of Preeclampsia Hospitalizations in the United States

Salman Zahid1, Mian Tanveer Ud Din2, Anum S Minhas3

  • 1Sands-Constellation Heart Institute, Rochester General Hospital, Rochester, New York, USA.

JACC. Advances
|June 28, 2024
PubMed

Insights

Preeclampsia disproportionately affects women of color, increasing their risk of death and cardiovascular complications, especially for high-income Black women compared to low-income White women.

Area of Science:

  • Obstetrics and Gynecology
  • Cardiovascular Medicine
  • Health Disparities Research

Background:

  • Preeclampsia is linked to increased in-hospital cardiovascular events and mortality.
  • Existing data show racial/ethnic disparities in preeclampsia outcomes.
  • Limited information exists on the combined impact of income and race on these outcomes.

Purpose of the Study:

  • To investigate racial and socioeconomic disparities in cardiovascular outcomes among delivery hospitalizations for preeclampsia.
  • To analyze the interaction between race/ethnicity and income on preeclampsia-related maternal morbidity and mortality.

Main Methods:

  • Analysis of National Inpatient Sample data (2004-2019) for 2,436,991 delivery hospitalizations with preeclampsia/eclampsia.
  • Stratification by race/ethnicity (White, Black, Hispanic, Asian/Pacific Islander) and median household income (low, medium, high).
  • Logistic regression and propensity-matched analyses adjusted for confounders.

Main Results:

  • Black, Hispanic, and A/PI women with preeclampsia had higher in-hospital mortality than White women across all income levels.
  • Hispanic women showed lower odds of peripartum cardiomyopathy (PPCM) compared to White women.
  • Significant interactions between race/ethnicity and income were found for mortality and PPCM. High-income Black women had increased odds of PPCM, stroke, AKI, heart failure, arrhythmia, and VTE versus low-income White women.

Conclusions:

  • Significant racial/ethnic and socioeconomic disparities exist in preeclampsia-related inpatient mortality and cardiovascular outcomes.
  • Black, Hispanic, and A/PI women consistently face higher in-hospital mortality risks.
  • High-income Black women experienced a greater burden of cardiovascular complications compared to low-income White women.
Abstract

Keywords:
cardiovascular diseasedisparitiesmaternal healthpreeclampsiarace/ethnicitysocioeconomic status

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