Prevalence of hypertensive disorders of pregnancy and chronic hypertension increased throughout the COVID-19 pandemic in South Carolina (2015-2021).

Abstract

Hypertensive disorders of pregnancy (HDP) and chronic hypertension (CHTN) are related to maternal and infant morbidity and mortality. We aimed to assess HDP and CHTN prevalence changes before (January 2015-February 2020) and during the COVID-19 pandemic (March 2020-December 2021) in South Carolina (SC). SC live births (2015-2021) were included (194,841 non-Hispanic White [NHW]); 108,195 non-Hispanic Black [NHB]; 25,560 Hispanic; 16,346 other race/ethnicity). Linked birth certificate and hospitalization/ED data was used. Relative risks (RRs) and 95 percent CIs adjusted for potential confounders estimated HDP and CHTN risk before and during the pandemic. HDP risk is associated with a one-year increase in calendar time pre-pandemic differed by race/ethnicity. Corresponding RRs (95 percent CIs) were 1.06 (1.05-1.06) in NHW, 1.07 (1.06-1.07) in NHB, 1.07 (1.06-1.09) in Hispanic and 1.09 (1.07-1.12) for other races/ethnicities. During the pandemic, RRs (95 percent CIs) attenuated slightly remaining significant (NHW, 1.03 [1.01-1.04]; NHB, 1.04 [1.02-1.05]; Hispanic, 1.04 [1.02-1.07]; other races/ethnicities, 1.06 [1.04-1.09]). Increasing race-ethnic group-specific trends from 2015 to 2021 were reported for CHTN (NHW, 1.09 [1.08-1.10]; NHB, 1.09 [1.08-1.10]; Hispanic, 1.08 [1.05-1.12]; other races/ethnicities, 1.15 [1.11-1.19]). HDP and CHTN's increasing prevalence from 2015 to 2021 differed by race/ethnicity, with HDP impacted by the pandemic and upward trends observed for both conditions after adjustment. Screening, diagnostic, and reporting practices across different data sources and actual changes may impact HDP and CHTN prevalence.