Observational studyWomen's health issues : official publication of the Jacobs Institute of Women's Health
Social Determinant Pathways to Hypertensive Disorders of Pregnancy Among Nulliparous U.S. Women.
Observational study in Women's health issues : official publication of the Jacobs Institute of Women's Health. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed.
- Beyond Proxies: Environment, Neighborhood, and Racial Disparities in Hypertensive Disorders of Pregnancy.AJPM focus · 2026Article
- Long-term neurological consequences of hypertensive disorders of pregnancy: Implications for postpartum monitoring and intervention.World journal of methodology · 2026Article
- Racial Disparities and the Use of Artificial Intelligence for Predicting Maternal Mortality: A Literature Review.Epidemiologia (Basel, Switzerland) · 2026Review
- Postpartum severe maternal morbidity: A longitudinal analysis of the association with economic segregation and neighborhood deprivation in Georgia, USA 2016-2022.Social science & medicine (1982) · 2026Article
- Allostatic Load Mediates Associations Between Race and Ethnicity and Hypertensive Disorders of Pregnancy.Obstetrics and gynecology · 2026Article
- Minimum Wage Policies and Obstetric Disorders in the U.S.American journal of preventive medicine · 2026Article
- Postpartum lipid dysregulation in African American women who experienced cardiometabolic complications of pregnancy.iScience · 2025Article
- Explaining Racial and Ethnic Disparities in Hypertension and Diabetes during Pregnancy in the United States (2016-2022): A Decomposition Analysis.Journal of racial and ethnic health disparities · 2025Article
- Lifetime history of hypertensive disorders of pregnancy is associated with shorter sleep duration and more sleep disturbance in midlife: results from the Project Viva women's health cohort.Biology of sex differences · 2025Article
- Closer look at the cardiovascular and metabolic predictors of postpartum depression.World journal of psychiatry · 2025Article
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Authors and funding
2 authors.
Funding
Abstract
backgroundHypertensive disorders of pregnancy are a leading cause of maternal morbidity and mortality in the United States and impact Black mothers at disproportionately higher rates. Hypertensive disparities among racialized groups are rooted in systemic inequalities, and we hypothesize that clinical markers of allostatic load capture embodied disparities in stressors that can link upstream social determinants of health with downstream hypertensive outcomes.
methodsWe analyzed observational cohort data from the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-Be (n = 6,501) and developed a structural equation model linking latent social determinants of health, longitudinal markers of allostatic load across gestation, and hypertensive pregnancy outcomes in a multigroup framework.
resultsNon-Hispanic Black mothers-to-be (n = 1,155) showed higher rates of hypertensive disorders of pregnancy (32%) than non-Hispanic white women (n = 5,346, 23%). Among both groups, the social environment showed stronger direct effects on allostatic markers than via behaviorally mediated dietary, exercise, or smoking pathways. Demographic aspects of the social environment (e.g., household income, partnered status) were the most salient predictor of hypertensive risk and showed stronger effects among Black women.
conclusionsEmbodied stress rooted in the social environment is a major path driving maternal hypertensive disparities in the United States, with effects that vary across racialized groups. These pathway findings underscore the greater impact of systemic stressors relative to individual health behaviors. More comprehensive and detailed analyses of sociostructural domains are needed to identify promising avenues for policy and intervention to improve maternal health.
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