Preeclampsia in Different Racial and Economic Groups
Around 140-million births happen worldwide annually. These pregnancies increase the risk of many life-threatening health complications in mothers. Common risks include: depression, gestational diabetes, anemia, and preeclampsia. Some prenatal tests performed during pregnancy can help prevent some of these problems or diagnose them early in the pregnancy. However, race and low socioeconomic status have caused Black women to have a maternal mortality rate of 2.5 to three times higher than Caucasian women. This cannot be solved by medical tests.
Preeclampsia, also known as “toxemia," is a pregnancy-related complication in which women have high blood pressure, protein in their urine, and swelling in their legs, feet, and hands. It can lead to serious, even fatal, complications for the mother and the child. The condition could drive the separation of the placenta from the uterus (placental abruption), cause preterm birth, and stillbirth. In some cases, preeclampsia can lead to organ failure in the lungs, kidneys, liver, heart, and brain. In severe cases, preeclampsia can develop into eclampsia, which includes seizures. The main impact on the fetus is undernutrition as a result of uteroplacental vascular insufficiency, which leads to growth restriction. One out of every 25 women in the United States develop preeclampsia. The condition may begin 20-weeks into a pregnancy; however, it can occur earlier or later. Unfortunately, the only treatment for preeclampsia is delivery.
Preeclampsia has disproportionately affected several racial and lower socioeconomic groups. Racial and ethnic minority groups, such as non-Hispanic Black women and American Indian or Alaskan Native women, are widely reported to be disproportionately affected by preeclampsia. Black women experienced preeclampsia or eclampsia in 69.8 of every 1000 deliveries, compared with 43.3 per 1000 deliveries in White women. One explanation for the increased amount of preeclampsia among Black women is assumed to be related to the increased incidence of chronic hypertension in that population. This results in the increased risk of developing preeclampsia, eclampsia, or pregnancy-aggravated hypertension among women with chronic hypertension.
Several elements of pregnancy-related complications are results of racism and low socioeconomic status. Obesity, chronic hypertension, diabetes, and sleep disorders increase the risk of preeclampsia. These factors can be created by poor food access, lower education, and weaker employment opportunities. There is a correlation between low-income areas and people of color, so these causes affect them and their healthcare the most.
Another way in which preeclampsia disproportionately affects lower socioeconomic mothers is in the diagnosing stage. Lack of transportation and having multiple jobs is more common among mothers with a lower income. These responsibilities may lead to missing an appointment with their obstetrician-gynecologist, requiring a reschedule which may take some time. This means preeclampsia may take longer to diagnose and more severe issues, such as organ damage and seizures, may occur. These women are also more likely to have long-term consequences of preeclampsia, including chronic hypertension and cardiovascular disease progression.
Women with a lower socioeconomic status need more viable access to transportation and healthier environments. This, in turn, will decrease their risk for developing diseases that affect their health during pregnancy. Maternal health disparities within different racial and economic groups need to be improved and taken seriously.
“Pregnant African-American Women Far More Likely to Have Pre-Eclampsia than White Women.” Norton Healthcare, 16 May 2018, nortonhealthcare.com/news/pregnant-african-american-women-pre-eclampsia.
Haelterman, Edwige, et al. “Social Deprivation and Poor Access to Care as Risk Factors for Severe Pre-Eclampsia.” PubMed.Gov, 10 Nov. 2003, pubmed.ncbi.nlm.nih.gov/14557007.
Johnson, Jasmine D. D., and Judette M Louis. “Does Race or Ethnicity Play a Role in the Origin, Pathophysiology, and Outcomes of Preeclampsia? An Expert Review of the Literature.” American Journal of Obstetrics and Gynecology, 2020. Crossref, doi:10.1016/j.ajog.2020.07.038.