Abstract P235: Racial/ethnic and Geographic Disparities in Cardiovascular Health Among Pregnant Women in The United States

Abstract

Life’s Simple 7 (LS7) developed by the American Heart Association (AHA) reframes cardiovascular disease (CVD) into terms of cardiovascular health (CVH). Large disparities in CVH exist in the general population. However, little is known about the CVH status and its disparities among pregnant women. We used data from two nationally representative surveys to assess racial/ethnic and geographic disparities in pregnancy CVH. Racial/ethnic disparities were examined using data from the 1999-2016 National Health and Nutrition Examination Survey (NHANES). Following LS7, each CVH metric was categorized into poor, intermediate, or ideal. Women with ≥ 4 ideal metrics were determined as having ideal pregnancy CVH. Data from the 2001-2017 Behavioral Risk Factor Surveillance System (BRFSS) were used to identify geographic disparities in pregnancy CVH as determined by self-report and categorized into poor or ideal. Women with > 3 poor metrics were considered as having poor pregnancy CVH. Among the 1,310 pregnant women identified from the NHANES, a lower ideal CVH rate was observed among non-Hispanic Blacks (27.6%), while there were small differences among other racial/ethnic groups (non-Hispanic Whites: 40.5%, Hispanics: 39.7%, and others: 34.7%). Comparing with Non-Hispanic Whites, non-Hispanic Blacks had significantly lower odds to meet an ideal CVH (OR: 0.55, 95% CI: 0.31, 0.97) after adjusting for sociodemographic status. A total of 19,259 pregnant women were identified from the BRFSS. Large geographic disparities in poor pregnancy CVH at the state-level were observed with substantial temporal variations, ranging from 11.7% (Vermont, 2001-2006) to 49.8% (Arkansas, 2013-2017). Continuously increasing rates of poor pregnancy CVH were found in 22 states, while only 2 states (i.e. Kentucky and Washington DC) had continuously decreasing rates in 2001-2017. More efforts are warranted to understand and address these large and increasing disparities in pregnancy CVH.