Hypertensive Disorders of Pregnancy During the COVID-19 Pandemic: A Population-Based Study [ID: 1380265]

INTRODUCTION: We previously reported that the prevalence of hypertensive disorders of pregnancy (HDP) increased during the COVID-19 pandemic. We aimed to ascertain potential sociodemographic factors contributing to this association. METHODS: This was a retrospective analysis of the U.S. Centers for Disease Control and Prevention Natality Live Birth database (2016–2020). The prevalence of HDP, defined as a composite of gestational hypertension, preeclampsia, and eclampsia, was compared between the COVID-19 pandemic group (births from April 1, 2020, to December 31, 2020; n=2,728,674) and the pre-pandemic group (births from January 1, 2016, to February 29, 2020; n=15,967,803). A comparison of the prevalence of HDP among maternal sociodemographic factors and pregnancy characteristics between the two groups was also performed using χ 2 test. Multivariable logistic regression was used to adjust for potential confounders. Statistical significance was set at P <.05. RESULTS: We detected an overall increase in odds of HDP during the COVID-19 pandemic period (8.7% versus 7.1%, adjusted odds ratio 1.25, 95% CI 1.24–1.26). The highest prevalence of HDP during the pandemic was seen in similar sociodemographic subgroups as in the pre-pandemic group, such as older maternal age, patients with some college credit, private insurance, and non-Hispanic Black race. A marked increase in HDP prevalence was noted during the pandemic in most maternal characteristic subgroups evaluated, with the greatest noted in Asian individuals and tobacco users. Interestingly, chronic hypertension, which was more prevalent during the pandemic period (1.2% versus 0.9%, P ≤.001), was associated with a lower prevalence of HDP during that time. CONCLUSION: The prevalence of HDP increased in the United States during the COVID-19 pandemic among all sociodemographic factors evaluated. Although chronic hypertension was more prevalent during the pandemic period, it had a lower effect on the development of HDP during that time.