# Nativity, Race, Ethnicity, and Hypertensive Disorders During Pregnancy

## TL;DR

This study finds that foreign-born Black and Hispanic mothers have lower rates of pregnancy-related hypertension compared to US-born mothers.

## Contribution

The study provides new evidence on how nativity affects hypertensive disorders in pregnancy among racial and ethnic minority groups.

## Key findings

- Foreign-born Black mothers had significantly lower gestational hypertension rates than US-born Black mothers.
- Foreign-born Hispanic mothers had lower rates of gestational hypertension and eclampsia compared to US-born Hispanic mothers.
- Overall, foreign-born mothers across all racial and ethnic groups had lower rates of hypertensive disorders than US-born mothers.

## Abstract

Background: Previous research has examined the idea of the healthy immigrant effect and its potential application to pregnancy-related hypertensive disorders, particularly inracial and ethnic minority groups. The aim of this study is to examine how nativity, race, and ethnicity are related to prevalence of pregnancy-related hypertensive disorders. Methods: A retrospective cohort study was conducted using data from the PRAMS CDC dataset. These data were analyzed via Χ2 comparisons of prevalence of pregnancy-related hypertensive disorders in foreign and US-born mothers, including subgroup analyses for Black and Hispanic women. Results: A sample size of 63,648 was analyzed, and revealed significant differences in the prevalence of gestational hypertension between US-born vs. foreign-born Black mothers (12.6% vs. 8.0%, Χ2 (1, N = 12,046) = 36.92, p < 0.001), Hispanic mothers (9.5% vs. 7.2%, Χ2 (1, N = 11,524) = 18.236, p < 0.001), and the larger sample of mothers across all reported racial and ethnic backgrounds (11.0% vs. 7.0%, Χ2 (1, N = 63,648) = 163.835, p < 0.001). The results also revealed a significant difference in the prevalence of hypertension eclampsia between US-born and foreign-born Hispanic mothers (0.8% vs. 0.3%, Χ2 (1, N = 11,152) = 8.480, p = 0.004). Conclusions: The study results showed evidence of significantly lower prevalence of pregnancy-related hypertensive disorders among foreign-born mothers as compared to their US-born counterparts, both in the full study sample and specifically in the subsamples of women who self-identified as Black and women who self-identified as Hispanic. These variances by nativity, race, and ethnicity provide further insight into how the healthy immigrant effect can apply to pregnancy-related hypertensive disorders, particularly for women of racial and ethnic minorities.