Dodds Leah V, Feaster Daniel J, Kershaw Kiarri N, Gunderson Erica P, Rundek Tatjana, Paidas Michael, Elfassy Tali
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 States.
Int J Cardiol Cardiovasc Risk Prev. 2025 Mar 6;25:200381. doi: 10.1016/j.ijcrp.2025.200381. eCollection 2025 Jun.
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.
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.
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.
RRS was not associated with HDP among Black women. Future research should consider multifaceted factors through which racial segregation may relate to maternal outcomes.
黑人女性患妊娠高血压疾病（HDP）的风险更高。种族居住隔离（RRS）导致了种族健康差异。本研究调查了美国黑人经产妇中RRS与HDP发病之间的关联。
青年成人冠状动脉风险发展研究是一项队列研究，研究对象为来自美国四个城市的18至30岁的黑人和白人成年人，于1985年招募，随访超过30年。RRS使用局部Getis-Ord Gi∗统计量进行测量，将社区分为高（Gi∗>1.96）、中（Gi∗ 0-1.96）或低（Gi∗<0）三类。在至少有一次基线后妊娠的黑人女性中，HDP通过自我报告为妊娠期高血压、先兆子痫或子痫。广义混合模型确定了RRS与HDP之间的关联，针对嵌套在黑人女性（n = 598）中的妊娠（n = 941），并对年龄、随访时间、怀孕时间、教育程度、收入、BMI、身体活动、吸烟、高血压、基线产次和累积妊娠次数进行了调整。
平均年龄为23.1岁（标准差：3.6），22.7%的人报告在至少一次妊娠中患有HDP。高RRS社区中HDP的累积发病率为23.0%，中RRS社区为20.6%，低RRS社区为23.7%。完全调整后的模型显示，与高RRS和HDP相比，中RRS（比值比：1.11；[95%置信区间：0.52，2.40]）或低RRS（比值比：0.94；[95%置信区间：0.42，2.16]）与HDP之间无显著关联。
黑人女性中RRS与HDP无关。未来的研究应考虑种族隔离可能与孕产妇结局相关的多方面因素。
