Hypertensive disorders of pregnancy rose 74% in US births since 2016

Design

Cross-sectional analysis of national vital statistics

Population

33,363,927 US live births, 2016 to 2024

Primary outcome

Age-standardised rate of hypertensive disorders of pregnancy

Effect

62.7 to 109.1 per 1,000 live births; average annual percent change 7.2%

A cross-sectional analysis in Obstetrics & Gynecology (6 October) used US national birth data covering 33.4 million live births from 2016 to 2024. Age-standardised rates of hypertensive disorders of pregnancy rose from 62.7 to 109.1 per 1,000 live births, an average annual increase of 7.2%, with a steeper climb from 2021.

The rise occurred in every racial and ethnic group. Relative increases were largest among Asian (9.7% a year) and multiracial women, while absolute rates in 2024 were highest among American Indian or Alaska Native (143.7 per 1,000) and Black women (132.7 per 1,000).

Birth-certificate data cannot separate a true increase from changes in diagnosis, blood pressure thresholds or recording, and the study does not explain the 2021 inflection. The practical message is about workload: roughly one pregnancy in ten now carries this diagnosis in the US, which makes postnatal blood pressure follow-up and long-term cardiovascular risk counselling a routine, not occasional, task.

• Expect hypertensive disorders in about one in ten pregnancies in comparable populations and staff postnatal blood pressure checks accordingly.
• Make sure every woman with a hypertensive disorder leaves with a postnatal blood pressure plan.
• Record a hypertensive pregnancy in the long-term record as a cardiovascular risk factor for later review.
• Review aspirin prophylaxis eligibility at booking for women with risk factors for pre-eclampsia.

Why it matters

A diagnosis this common changes the postnatal blood pressure clinic from an add-on to a core service.

Don't overread it

Birth-certificate data cannot tell a real rise from changes in how the condition is diagnosed and recorded.

The statistics, in plain English

An average annual percent change of 7.2% compounds over eight years into the 74% overall rise. These are age-standardised rates, so the increase is not simply explained by older mothers.

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