Peripartum hypertension and neonatal outcomes across races: 2016-2022

Maternal hypertension, a major pregnancy complication, can adversely affect newborn health. Our study investigated racial/ethnic disparities in neonatal outcomes among hypertensive pregnant women in the US.

Using data from the CDC WONDER Natality database, we conducted a retrospective cohort study focusing on live births to hypertensive mothers from 2016 to 2022. We calculated rates [95% CI] per 1000 live births for NICU admissions, neonatal assisted ventilation, low birth weight, and in-hospital mortality across racial/ethnic groups and regions.

We analyzed 2,392,664 live births to hypertensive women. In-hospital neonatal mortality rates were highest in Black American women (BA) (3.6 [3.5, 3.8]). Neonatal assisted ventilation rates were highest in Native Hawaiian/Pacific Islander women (NH/PI) (131.8 [123.4, 140.7]) and low birth weight rates were highest in BA (235.1 [233.9, 236.3]). Across all races, female neonates had a higher rate of low birth weight compared to male neonates, while male neonates had higher incidences of NICU admissions, neonatal assisted ventilation, and in-hospital mortality. The Midwest had the highest rates for NICU admissions in NH/PI (254.2 [217.2, 295.2]), neonatal assisted ventilation in American Indian/Alaska Native women (143.8 [133.2, 155.1]), and in-hospital mortality in BA (4.1 [3.7, 4.5]). The South had the highest rate of low birth weight for BA (244.4 [242.9, 246.0]).

Significant racial and regional disparities exist in neonatal outcomes among hypertensive women in the US, with BA mothers experiencing the poorest outcomes. Further research is necessary to develop targeted interventions for high-risk populations.