Abstract 16942: Maternal Hypertension and Low Birth Weight: Do Socio-Economic and Racial/Ethnic Disparities Matter?
Background: Maternal hypertension (HTN) can increase risk for low birth weight (LBW, weight< 2,500 grams), a compelling, unsolved health problem. Identification of high risk groups for HTN-related LBW is essential to designing evidence-based interventions addressing vulnerable populations. We hypothesized that selected disparities contribute to HTN-related LBW.
Methods: A case-control study of 114,298 births in the year 2010 in Ohio was conducted. Comprehensive Ohio birth data were obtained from Ohio Department of Health. Maternal HTN status was classified as: pre-pregnancy HTN, gestational HTN, or non-hypertensive. Mothers utilizing Medicaid or the Federal Special Supplemental Nutrition Program for Women, Infants and Children were considered of low socio-economic status (SES). Adjusted odds ratios (OR) for LBW in relation to mother's HTN status, race, ethnicity, and SES were obtained using multivariable logistic regression (SAS software), adjusting for known confounders - gestational age, mother's age, pre-pregnancy or gestational diabetes, pre-pregnancy and pregnancy smoking status, and plurality.
Results: Maternal pre-pregnancy HTN and gestational HTN were associated with a statistically significant increase in LBW risk (adjusted OR 1.286, 95% CI 1.061-1.560, p<0.05, and adjusted OR 1.588, 95% CI 1.417-1.780, p<0.01, respectively). Adjusted for HTN status and confounders, African American and Asian mothers had a statistically significantly higher risk of delivering a LBW infant than Caucasian mothers (adjusted OR 1.931, 95% CI 1.763-2.115, p<0.01, and adjusted OR 1.780, 95% CI 1.522-2.083, p<0.01, respectively), and Hispanic ethnicity was associated with lower risk of LBW (adjusted OR 0.750, 95% CI 0.615-0.915, p<0.01). When adjusted for confounders, effect of low SES on LBW was only borderline significant (adjusted OR 1.081, 95% CI 0.990-1.180, p=0.08).
Conclusions: Adjusted for demographic and clinical confounders, maternal HTN increases risk of LBW. Independently from HTN, racial/ethnic and SES disparities contribute to risk of LBW. Epidemiological phenomenon of Hispanic paradox extends its effect to the HTN-related LBW issue. Effect of low SES on HTN-related LBW may be partially attributed to racial disparities.
- © 2011 by American Heart Association, Inc.