Abstract 17802: Racial Disparities in the Association of Pre-Pregnancy Cardiometabolic Risk Factors With Adverse Pregnancy Outcomes

Abstract

Background/Hypothesis: Racial and ethnic disparities and worsened poor pre-pregnancy cardiometabolic health are individually recognized to increase risk for adverse pregnancy outcomes (APOs). However, the interaction of race and ethnicity with pre-pregnancy cardiometabolic factors in relationship with APO risk is less well understood. Aims: To evaluate racial and ethnic disparities in the risk association of cardiometabolic factors with APOs in a national population. Methods: We analyzed Natality Data from the National Vital Statistics System of the National Center for Health Statistics between 2016-2017. We used multivariable logistic regression to estimate adjusted odds of APOs (preterm birth, gestational diabetes, and pregnancy-induced hypertension) with pre-pregnancy cardiometabolic factors: chronic hypertension, obesity, and diabetes, stratified by race and ethnicity. Population attributable fractions (PAFs) were calculated to assess the proportion of APOs attributable to pre-pregnancy cardiometabolic risk factors. Results: Among 7,460,633 births, presence of pre-pregnancy hypertension, obesity and diabetes were differentially associated with APO risk by race and ethnicity (Table 1). Overall, non-Hispanic Black women had the greatest incidence of preterm birth (16.7%), while American Indian/Native women had the greatest incidence of pregnancy-induced hypertension (10.1%) and gestational diabetes (12.6%). Conclusion: There is heterogeneity by race and ethnicity in the association of pre-pregnancy cardiometabolic factors with APOs. Non-Hispanic Black and American Indian/Native women have the overall greatest burden of most APOs, including preterm birth, pregnancy-induced hypertension, and gestational diabetes. Targeted preventive efforts, with consideration of stressors for individual racial and ethnic groups, should be undertaken to improve cardiometabolic health prior to conception to lower risk of APOs.