MATERNAL HYPERTENSION AND ASSOCIATED PREGNANCY COMPLICATIONS AMONG AFRICAN-AMERICAN AND OTHER WOMEN IN THE UNITED-STATES

Objective: To characterize maternal hypertension and related pregnancy complications among African-American and other women in the United St ates. Methods: Using data from the National Hospital Discharge Survey, we analyzed the incidence and clinical spectrum of maternal hypertens ion among African-American women who delivered in hospital during 1988 -1992. Maternal hypertension consisted of: pregnancy-induced hypertens ion and chronic hypertension preceding pregnancy, including pregnancy- aggravated hypertension. Pregnancy-induced hypertension included preec lampsia, eclampsia, and transient hypertension. Incidence rates (per 1 000 deliveries) and 95% confidence intervals (CI) were calculated by t ype of hypertension and demographic characteristics. Risk ratios and 9 5% CIs for adverse pregnancy outcomes among women with hypertension we re also calculated. Results: The overall incidence of all causes of ma ternal hypertension was 64.2, and of chronic hypertension preceding pr egnancy it was 25.0 per 1000 deliveries among African-American women, an excess of 15.6 and 14.5 cases per 1000 deliveries, respectively, co mpared with rates for other women. The risks of preterm delivery and i nadequate fetal growth were similarly increased for all hypertensive w omen, regardless of race. However, hypertensive African-American women were at a threefold greater risk of pregnancies complicated by antepa rtum hemorrhage, an association that was not observed in other women. Development of preeclampsia and eclampsia irrespective of race was abo ut four times higher among women with chronic hypertension preceding p regnancy than among those without chronic hypertension. Conclusion: Th e excess incidence of maternal hypertension, particularly chronic hype rtension, may contribute to adverse maternal and fetal pregnancy outco mes and the disparity in outcomes observed between African-American an d other women in the U.S. These findings provide a specific focus for further clinical outcomes research and assessment of prenatal manageme nt in African-American women.