Abstract 013: Racial Disparities in Maternal Hypertension and Pregnancy Outcomes a Population-Based Study

Objective: Maternal pre-pregnancy hypertension is an established risk factor for preterm births and infant deaths. We sought to investigate the effects of maternal pre-pregnancy hypertension and tobacco use on preterm and infant deaths. Methods: We analyzed National Vital Statistics System’s 2013 and 2015 linked birth/ infant death data from a total sample of 6,629,652 live births. There were 11,782 preterm deaths due to “Newborn affected by maternal factors and by complications.” Maternal factors and complications were defined as deaths at less than 1 year of age with ICD-10 codes P00-P04. Regression model was accounted for tobacco use, cigarette use before and during pregnancy, prenatal care, maternal age and demographics. Results: Disease specific preterm mortality due to pre-pregnancy hypertension was 1.9 per/1000 live births. Preterm risk increased by two folds (adjusted odds ratio (AOR)=2.12; 95% confidence interval (CI) 1.92-2.18) with maternal pre-pregnancy hypertension history. Presence of pre-pregnancy hypertension and tobacco use doubled the risk of preterm (AOR=3.82 (95% CI: 3.67-4.82). African American mothers with pre-pregnancy hypertension were 1.72 time more likely to have preterm mortality than White females. Conclusion: Black race, maternal risk factor pre-pregnancy hypertension and tobacco use during pregnancy were associated with higher risk of preterm mortality. Further investigation is crucial to better understand the risk factors for the disparities in preterm so that women who are at risk pre-pregnancy can be identified and provided risk-specific services.