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Cited by 125Pregnancy and preeclampsia studiesNeurological Complications and SyndromesBlood Pressure and Hypertension Studies

Trends in the incidence of new-onset hypertensive disorders of pregnancy among rural and urban areas in the United States, 2007 to 2019

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Cameron, Natalie A., Everitt, Ian, Seegmiller, Laura E., Yee, Lynn M., Grobman, William A., Khan, Sadiya S.·2022·Journal of the American Heart Association
DOI 10.1161/jaha.121.023791PMC PMC9238536
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Abstract

Background: Hypertensive disorders of pregnancy are growing public health problems that contribute to maternal morbidity, mortality, and future risk of cardiovascular disease. Given established rural‐urban differences in maternal cardiovascular health, we described contemporary trends in new‐onset hypertensive disorders of pregnancy in the United States. Methods and Results: We conducted a serial, cross‐sectional analysis of 51 685 525 live births to individuals aged 15 to 44 years from 2007 to 2019 using the Centers for Disease Control and Prevention Natality Database. We included gestational hypertension and preeclampsia/eclampsia in individuals without chronic hypertension and calculated the age‐adjusted incidence (95% CI) per 1000 live births overall and by urbanization status (rural or urban). We used Joinpoint software to identify inflection points and calculate rate of change. We quantified rate ratios to compare the relative incidence in rural compared with urban areas. Incidence (95% CI) of new‐onset hypertensive disorders of pregnancy increased from 2007 to 2019 in both rural (48.6 [48.0–49.2] to 83.9 [83.1–84.7]) and urban (37.0 [36.8–37.2] to 77.2 [76.8–77.6]) areas. The rate of annual increase in new‐onset hypertensive disorders of pregnancy was more rapid after 2014 with greater acceleration in urban compared with rural areas. Rate ratios (95% CI) comparing incidence of new‐onset hypertensive disorders of pregnancy in rural and urban areas decreased from 1.31 (1.30–1.33) in 2007 to 1.09 (1.08–1.10) in 2019. Conclusions: Incidence of new‐onset hypertensive disorders of pregnancy doubled from 2007 to 2019 with persistent rural‐urban differences highlighting the need for targeted interventions to improve the health of pregnant individuals and their offspring.

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  • Hypertensive pregnancy disorders affect 10% of pregnancies.

    “hypertensive pregnancy disorders 10% (Cameron et al., 2022)”

    From Pregnancy-related maternal physiological adaptations and fetal chemical exposure (2023) · cites this paper as Cameron et al., 2022

    The Methods and Results section (page unavailable) reports new-onset hypertensive disorders in 2019 at 83.9 per 1,000 rural live births and 77.2 per 1,000 urban live births—about 8%, not 10%. The study covers US live births, so it does not establish a 10% figure for pregnancies generally. (LLM, conf=0.84)

    Experimental — accuracy not yet measured

  • Pregnancy-related complications are common.

    “pregnancy complications are common; for example, gestational diabetes affects 14% of all pregnancies (Wang et al., 2022), and hypertensive pregnancy disorders 10% (Cameron et al., 2022).”

    From Pregnancy-related maternal physiological adaptations and fetal chemical exposure (2023) · cites this paper as Cameron et al., 2022

    The Results (Overall Trends in Hypertensive Disorders of Pregnancy; page unavailable) show that hypertensive disorders are common: in 2019, incidence was 83.9 per 1,000 live births in rural areas and 77.2 per 1,000 in urban areas. That supports the general point, but not the cited figure of 10% of all pregnancies; the study measured live births and reports rates closer to 8%. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

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Cited by

Sorted by citations

Authors
Cameron, N. A., Everitt, I., Seegmiller, L. E., Yee, L. M., Grobman, W. A., & Khan, S. S.
Affiliations
Northwestern University (US)
Corresponding author
Khan, Sadiya S.
ORCID
Venue
Journal of the American Heart Association
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2022-01-18
Volume
11
Issue
2
Pages
e023791-e023791
ISSN
2047-9980 (ISSN-L)
DOI
10.1161/jaha.121.023791
PMC
PMC9238536
OpenAlex
W4206036861
Cited by
125
References
3
Citations by year
2026: 24 · 2025: 39 · 2024: 29 · 2023: 24 · 2022: 9
FWCI
25.33
Type
journal article
Language
en
Open access
Licence
cc-by-nc-nd
Locations
  • Journal of the American Heart Association (publishedVersion, cc-by-nc-nd)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
  • National Institute on Aging (P30AG059988)
  • National Institute of Diabetes and Digestive and Kidney Diseases (R01DK092939)
Topics
  • Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy and preeclampsia studies
  • Health Sciences › Medicine › Psychiatry and Mental health › Neurological Complications and Syndromes
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
Keywords
hypertensive disorders of pregnancy, gestational hypertension, preeclampsia, eclampsia, incidence trends, urban-rural differences, maternal health, cardiovascular risk in pregnancy, live birth
MeSH terms
Adolescent, Adult, Cross-Sectional Studies, Eclampsia, Female, Humans, Pre-Eclampsia, Pregnancy, United States, Incidence, Hypertension, Pregnancy-Induced, Young Adult

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