Abstract 180: South Asian Nativity And Cardiometabolic Risk Factors In Pregnant Women In The United States

Abstract

Introduction: Women of South Asian (SA) descent have high cardiometabolic risk which may impact obstetric and long-term morbidity and mortality. Data regarding contemporary epidemiology of cardiometabolic risk factors in pregnant women are scarce. Therefore, we sought to investigate contemporary epidemiology of cardiometabolic risk factors in pregnant women in the US with a focus on SA-born women in comparison with United States (US)-born and women born in the rest of the world (ROW). Methods: We used the natality database 2016-2020 to investigate the incidence/prevalence of cardiometabolic risk factors (pre-pregnancy diabetes [pre-DM], gestational diabetes [GDM], pre-pregnancy hypertension [pre-HTN], gestational hypertension [GHTN], smoking, and obesity) in the US, by country of nativity. SA women were defined as women born in Bangladesh, India, Nepal, Pakistan, and Sri Lanka. US women were those born in the US (including US Virgin Islands) and ROW refers to women born in other countries. Results: A total of 18,916,536 pregnancies were studied (370,619 SA; 14,745,134 US; and 3,800,783 ROW). SA women had higher risk of pre-DM compared with US and ROW (1.2% vs 0.9% vs 1.0%), GDM (15.7% vs 5.9% vs 8.8%), but lower rates of pre-HTN (0.9% vs 2.3% vs 1.3%), GHTN (4.2% vs 7.8% vs 4.9%), obesity (11.2% vs 29.6% vs 20.2%), and smoking (0.1% vs 8.1% vs 0.6%). Between 2016 and 2020, there was a significant increase in cardiometabolic risk factors in SA women: pre-DM (1.2% to 1.5%), GDM (14% to 17.7%), pre-HTN (0.8% to 1.0%), GHTN (3.7% to 5.0%), obesity (10% to 12.4%). Conclusions: In this contemporary analysis of pregnant women in the US, SA women had higher risk of pre-DM and GDM compared with US and ROW women. Between 2016 and 2020, there was a significant increase in the rates of all cardiometabolic risk factors in SA women. Intensive preventive strategies should be implemented in high-risk SA pregnant women in the US.