Associations Between Racial Residential Segregation and Hypertensive Disorders of Pregnancy among Black women: The Coronary Artery Risk Development in Young Adults Study
Introduction: Black women are at greater risk of hypertensive disorders of pregnancy (HDP). Racial residential segregation (RRS) drives racial health disparities. This study investigates the association between RRS and the onset of HDP among Black parous women in the U.S. Methods: The Coronary Arter...
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Elsevier
2025-06-01
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| Series: | International Journal of Cardiology. Cardiovascular Risk and Prevention |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2772487525000194 |
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| author | Leah V. Dodds Daniel J. Feaster Kiarri N. Kershaw Erica P. Gunderson Tatjana Rundek Michael Paidas Tali Elfassy |
| author_facet | Leah V. Dodds Daniel J. Feaster Kiarri N. Kershaw Erica P. Gunderson Tatjana Rundek Michael Paidas Tali Elfassy |
| author_sort | Leah V. Dodds |
| collection | DOAJ |
| description | Introduction: Black women are at greater risk of hypertensive disorders of pregnancy (HDP). Racial residential segregation (RRS) drives racial health disparities. This study investigates the association between RRS and the onset of HDP among Black parous women in the U.S. Methods: The Coronary Artery Risk Development in Young Adults study is a cohort of Black and White adults aged 18–30 from four U.S. cities, recruited in 1985 and followed for over 30 years. RRS was measured using the local Getis-Ord Gi∗ statistic, categorizing neighborhoods as high (Gi∗ >1.96), medium (Gi∗ 0–1.96), or low (Gi∗ <0). Among Black women with at least one post-baseline pregnancy, HDP was self-reported as gestational hypertension, preeclampsia, or eclampsia. Generalized mixed models determined the association between RRS and HDP, for pregnancies (n = 941) nested within Black women (n = 598), and adjusting for age, follow-up time, time to pregnancy, education, income, BMI, physical activity, smoking, hypertension, baseline parity, and cumulative pregnancies. Results: The mean age was 23.1 years (SD: 3.6), with 22.7 % reporting HDP in at least one pregnancy. The cumulative incidence of HDP was 23.0 % in high, 20.6 % in medium, and 23.7 % in low RRS neighborhoods. Fully adjusted models showed no significant association between medium RRS (OR: 1.11; [95 % CI: 0.52, 2.40]) or low RRS (OR: 0.94; [95 % CI: 0.42, 2.16]) compared with high RRS and HDP. Conclusions: RRS was not associated with HDP among Black women. Future research should consider multifaceted factors through which racial segregation may relate to maternal outcomes. |
| format | Article |
| id | doaj-art-5cb9b2d4fa3243b1958dbfd5cb292f73 |
| institution | OA Journals |
| issn | 2772-4875 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Cardiology. Cardiovascular Risk and Prevention |
| spelling | doaj-art-5cb9b2d4fa3243b1958dbfd5cb292f732025-08-20T02:31:44ZengElsevierInternational Journal of Cardiology. Cardiovascular Risk and Prevention2772-48752025-06-012520038110.1016/j.ijcrp.2025.200381Associations Between Racial Residential Segregation and Hypertensive Disorders of Pregnancy among Black women: The Coronary Artery Risk Development in Young Adults StudyLeah V. Dodds0Daniel J. Feaster1Kiarri N. Kershaw2Erica P. Gunderson3Tatjana Rundek4Michael Paidas5Tali Elfassy6Department of Public Health Sciences, University of Miami Miller School of Medicine, United States; Corresponding author. Medical Scientist Training Program, Division of Prevention Science and Community Health, University of Miami, Miami, FL, 33136, United States.Department of Public Health Sciences, University of Miami Miller School of Medicine, United States; Department of Biostatistics, University of Miami Miller School of Medicine, United StatesDepartment of Preventive Medicine, Northwestern University, United StatesBernard J Tyson Kaiser Permanente School of Medicine, United StatesDepartment of Neurology, Evelyn F. McKnight Brain Institute, University of Miami Miller School of Medicine, United StatesDepartment of Obstetrics, Gynecology, and Reproductive Sciences, University of Miami Miller School of Medicine, United StatesKatz Family Division of Nephrology and Hypertension, University of Miami Miller School of Medicine, United StatesIntroduction: Black women are at greater risk of hypertensive disorders of pregnancy (HDP). Racial residential segregation (RRS) drives racial health disparities. This study investigates the association between RRS and the onset of HDP among Black parous women in the U.S. Methods: The Coronary Artery Risk Development in Young Adults study is a cohort of Black and White adults aged 18–30 from four U.S. cities, recruited in 1985 and followed for over 30 years. RRS was measured using the local Getis-Ord Gi∗ statistic, categorizing neighborhoods as high (Gi∗ >1.96), medium (Gi∗ 0–1.96), or low (Gi∗ <0). Among Black women with at least one post-baseline pregnancy, HDP was self-reported as gestational hypertension, preeclampsia, or eclampsia. Generalized mixed models determined the association between RRS and HDP, for pregnancies (n = 941) nested within Black women (n = 598), and adjusting for age, follow-up time, time to pregnancy, education, income, BMI, physical activity, smoking, hypertension, baseline parity, and cumulative pregnancies. Results: The mean age was 23.1 years (SD: 3.6), with 22.7 % reporting HDP in at least one pregnancy. The cumulative incidence of HDP was 23.0 % in high, 20.6 % in medium, and 23.7 % in low RRS neighborhoods. Fully adjusted models showed no significant association between medium RRS (OR: 1.11; [95 % CI: 0.52, 2.40]) or low RRS (OR: 0.94; [95 % CI: 0.42, 2.16]) compared with high RRS and HDP. Conclusions: RRS was not associated with HDP among Black women. Future research should consider multifaceted factors through which racial segregation may relate to maternal outcomes.http://www.sciencedirect.com/science/article/pii/S2772487525000194Hypertensive disorders of pregnancyMaternal healthSocial determinants of healthSegregationHealth disparitiesRacial inequities |
| spellingShingle | Leah V. Dodds Daniel J. Feaster Kiarri N. Kershaw Erica P. Gunderson Tatjana Rundek Michael Paidas Tali Elfassy Associations Between Racial Residential Segregation and Hypertensive Disorders of Pregnancy among Black women: The Coronary Artery Risk Development in Young Adults Study International Journal of Cardiology. Cardiovascular Risk and Prevention Hypertensive disorders of pregnancy Maternal health Social determinants of health Segregation Health disparities Racial inequities |
| title | Associations Between Racial Residential Segregation and Hypertensive Disorders of Pregnancy among Black women: The Coronary Artery Risk Development in Young Adults Study |
| title_full | Associations Between Racial Residential Segregation and Hypertensive Disorders of Pregnancy among Black women: The Coronary Artery Risk Development in Young Adults Study |
| title_fullStr | Associations Between Racial Residential Segregation and Hypertensive Disorders of Pregnancy among Black women: The Coronary Artery Risk Development in Young Adults Study |
| title_full_unstemmed | Associations Between Racial Residential Segregation and Hypertensive Disorders of Pregnancy among Black women: The Coronary Artery Risk Development in Young Adults Study |
| title_short | Associations Between Racial Residential Segregation and Hypertensive Disorders of Pregnancy among Black women: The Coronary Artery Risk Development in Young Adults Study |
| title_sort | associations between racial residential segregation and hypertensive disorders of pregnancy among black women the coronary artery risk development in young adults study |
| topic | Hypertensive disorders of pregnancy Maternal health Social determinants of health Segregation Health disparities Racial inequities |
| url | http://www.sciencedirect.com/science/article/pii/S2772487525000194 |
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