TY - JOUR
T1 - Association of Prepregnancy Cardiometabolic Health With Hypertensive Disorders of Pregnancy Among Historically Underrepresented Groups in the United States
AU - Kwapong, Yaa A.
AU - Boyer, Theresa
AU - Adebowale, Oluwalonimi
AU - Ogunwole, S. Michelle
AU - Vaught, Arthur Jason
AU - Ndumele, Chiadi E.
AU - Hays, Allison G.
AU - Blumenthal, Roger S.
AU - Michos, Erin D.
AU - Selvin, Elizabeth
AU - Coresh, Josef
AU - Minhas, Anum S.
N1 - Publisher Copyright:
© 2024 The Author(s).
PY - 2024
Y1 - 2024
N2 - BACKGROUND: Prepregnancy diabetes and obesity are associated with hypertensive disorders of pregnancy (HDPs). However, the proportion of cases of HDP in the population explained by diabetes and obesity (population attributable fraction), espe-cially among American Indian and Alaska Native and Native Hawaiian and Other Pacific Islander, is not well characterized. METHODS AND RESULTS: We conducted a cross-sectional analysis of data on individuals with a live singleton birth from the US National Vital Statistics System between 2016 and 2019. We used adjusted logistic regression to estimate the prevalence odds ratios of HDPs and tested interaction for race and ethnicity. We calculated the population attributable fraction for the effect of obesity and diabetes on HDPs. Among 13 201 338 birthing individuals, (mean age, 29±6 years), 7% had HDP. The prevalence of HDP was highest among American Indian and Alaska Native individuals (9.1%). Prepregnancy diabetes (preva-lence odds ratio, 2.63 [95% CI, 2.59–2.67]) and obesity (prevalence odds ratio, 2.95 [95% CI, 2.93–2.97]) were associated with HDPs. Compared with non-Hispanic White individuals, the association of diabetes with HDPs was strongest among Native Hawaiian and Other Pacific Islander (prevalence odds ratio, 3.05 [95% CI, 2.48–3.77]), and the association of obesity with HDP was strongest among Asian individuals (prevalence odds ratio, 3.44 [95% CI, 3.35–3.54]; all P for interaction <0.05). Population attributable fractions for diabetes and obesity were highest among Native Hawaiian and Other Pacific Islander individuals (diabetes, 3.7% [95% CI, 3.3%–4.0%]; and obesity, 45% [95% CI, 41.9%–47.8%]). CONCLUSIONS: Prepregnancy diabetes and obesity are associated with HDP across all racial and ethnic groups. Diabetes and obesity have highest population attributable fractions among Native Hawaiian and Other Pacific Islander individuals and should be aggressively targeted during childhood, adolescence, and young adulthood to reduce risk of HDPs.
AB - BACKGROUND: Prepregnancy diabetes and obesity are associated with hypertensive disorders of pregnancy (HDPs). However, the proportion of cases of HDP in the population explained by diabetes and obesity (population attributable fraction), espe-cially among American Indian and Alaska Native and Native Hawaiian and Other Pacific Islander, is not well characterized. METHODS AND RESULTS: We conducted a cross-sectional analysis of data on individuals with a live singleton birth from the US National Vital Statistics System between 2016 and 2019. We used adjusted logistic regression to estimate the prevalence odds ratios of HDPs and tested interaction for race and ethnicity. We calculated the population attributable fraction for the effect of obesity and diabetes on HDPs. Among 13 201 338 birthing individuals, (mean age, 29±6 years), 7% had HDP. The prevalence of HDP was highest among American Indian and Alaska Native individuals (9.1%). Prepregnancy diabetes (preva-lence odds ratio, 2.63 [95% CI, 2.59–2.67]) and obesity (prevalence odds ratio, 2.95 [95% CI, 2.93–2.97]) were associated with HDPs. Compared with non-Hispanic White individuals, the association of diabetes with HDPs was strongest among Native Hawaiian and Other Pacific Islander (prevalence odds ratio, 3.05 [95% CI, 2.48–3.77]), and the association of obesity with HDP was strongest among Asian individuals (prevalence odds ratio, 3.44 [95% CI, 3.35–3.54]; all P for interaction <0.05). Population attributable fractions for diabetes and obesity were highest among Native Hawaiian and Other Pacific Islander individuals (diabetes, 3.7% [95% CI, 3.3%–4.0%]; and obesity, 45% [95% CI, 41.9%–47.8%]). CONCLUSIONS: Prepregnancy diabetes and obesity are associated with HDP across all racial and ethnic groups. Diabetes and obesity have highest population attributable fractions among Native Hawaiian and Other Pacific Islander individuals and should be aggressively targeted during childhood, adolescence, and young adulthood to reduce risk of HDPs.
KW - cardiometabolic health
KW - disparities
KW - hypertensive disorders of pregnancy
KW - nativity
KW - race and ethnicity
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U2 - 10.1161/JAHA.124.035526
DO - 10.1161/JAHA.124.035526
M3 - Article
C2 - 39424428
AN - SCOPUS:85208602076
SN - 2047-9980
VL - 13
JO - Journal of the American Heart Association
JF - Journal of the American Heart Association
IS - 21
M1 - e035526
ER -