- Design
- Cross-sectional analysis of national vital statistics, 2016–2024
- Population
- 33,363,927 US live births
- Primary outcome
- Age-standardised rate of hypertensive disorders of pregnancy
- Effect
- 62.7 to 109.1 per 1,000 births (+74%); average annual change 7.2%
A cross-sectional analysis of more than 33 million US live births from national vital statistics found age-standardised rates of hypertensive disorders of pregnancy climbed from 62.7 to 109.1 per 1,000 births between 2016 and 2024 — an average rise of 7.2% a year, steepening from 2021.
The increase was seen in every racial and ethnic group. Relative rises were largest among Asian 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 rise from better detection or changed definitions, and the 2021 inflection coincides with the pandemic and coding shifts. Even so, the direction is consistent.
The same drivers — older mothers, obesity, diabetes — are rising in India. More hypertension in pregnancy means more women carrying a long-term cardiovascular risk that needs follow-up after the postnatal period.
- Check blood pressure properly at every antenatal visit, with a correctly sized cuff.
- Offer aspirin prophylaxis to women who meet your guideline's risk criteria for pre-eclampsia.
- Record a hypertensive pregnancy in the woman's long-term health record as a cardiovascular risk factor.
- Plan postpartum blood pressure review rather than leaving it to chance.
Why it matters
A condition once seen in one pregnancy in sixteen now affects about one in nine US births.
Don't overread it
Vital statistics cannot tell a real increase from better recording.
The statistics, in plain English
An average annual change of 7.2% compounds — over nine years that adds up to the 74% total. Age standardisation removes the effect of mothers getting older, so the rise is not explained by age alone.
Read the rest in the app
You have read your two free briefings this month. The app carries all 27 specialties, every morning, free — and this finding is waiting in it.
Scan to keep reading on your phone. No account needed to start.
Tomorrow morning, before your first patient
One edition a day for obstetrics & gynaecology, written by the desk, every claim tied to its paper. Six minutes.
Get the app — free