Gen Z and Millennials Twice As Likely To Develop Hypertension in Pregnancy



Even after accounting for age differences at conception, there are still higher rates of high blood pressure.

Pregnancy-related high blood pressure is on the rise and is one of the main causes of maternal death.

Premature birth or infant death are all risks that are exacerbated by high blood pressure during pregnancy for both the mother and the unborn child.

Black non-Hispanics and pregnant American Indian/Alaskan Natives are particularly affected

Compared to pregnant members of the baby boomer age, Gen Zers and millennials have a roughly two-fold increased risk of receiving a new diagnosis of high blood pressure during pregnancy, which includes preeclampsia and gestational hypertension. According to a recent Northwestern Medicine study, this remains the case even after accounting for age disparities at conception.

This finding is significant since it is generally accepted that women who become pregnant later in life are to blame for rising rates of high blood pressure during pregnancy. However, this study reveals that women from more recent generations are more likely to experience high blood pressure during pregnancy, independent of their age at the time of conception.

While there are various explanations for generational changes, according to corresponding study author Dr. Sadiya Khan, "we assume that this is, in large part, related to the documented generational deterioration in heart health." She works at Northwestern Medicine and is an assistant professor of medicine at Northwestern University Feinberg School of Medicine. More individuals with risk characteristics, such obesity, are becoming pregnant in more recent generations.

The risks, according to Khan, are great.

According to Khan, high blood pressure during pregnancy is a major cause of death for both the mother and the unborn child. Pregnancy-related high blood pressure is linked to an increased risk of heart failure and stroke in the mother as well as an increased risk of premature birth, growth restriction, and infant mortality.

The nearly two-fold increase in pregnancy-related hypertension incidence over the previous ten years has been noted in earlier study from Northwestern and the Centers for Disease Control and Prevention (CDC).

According to Khan, more than a million millennial women have already received a high blood pressure diagnosis during their first pregnancies. Racial and ethnic differences have also endured over the four generations that were analyzed. The new Northwestern study found that non-Hispanic American Indian/Alaskan Native and non-Hispanic Black women had the highest incidence of elevated blood pressure during pregnancy.                                                                                  
This is the first cross-generational study to examine patterns of pregnancy-related hypertension without regard to the mother's age or the year of delivery, according to Khan. This is crucial when considering the history of pronounced racial and ethnic disparities in this high-risk illness that affects both the mother and the unborn child. By starting life with a worse state of heart health, this creates a vicious cycle of generational health degradation.

The need to broaden our screening perspectives and increase our emphasis on prevention in all age groups before and during pregnancy, particularly among younger people who have traditionally not been considered to be at high risk, is the public health and clinical message from this work, according to study first author Dr. Natalie Cameron. She practices medicine for Northwestern Medicine and teaches it at Feinberg.

Khan claimed that telehealth/remote health prospects and mobile health technologies, such as wearable technology, have created potential to more fairly increase blood pressure surveillance.

The health of future generations can be improved beginning at birth through prevention and earlier identification, according to Khan.

The National Vital Statistics System Natality Database, which collects data from birth certificates for every live birth in the United States, was used to compile the study's data. The study includes information on more than 38 million people and focused on first pregnancies of persons between 1995 and 2019. Researchers were able to group the rates of hypertensive disorders of pregnancy by the mother's birth year (maternal birth cohort) and their self-identified race or ethnicity using the data at their disposal.

Reference: "Association of Birth Year of Pregnant Individuals With Trends in Hypertensive Disorders of Pregnancy in the United States, 1995-2019" by Natalie A. Cameron, MD, Lucia C. Petito, PhD, Nilay S. Shah, MD, MPH, Amanda M. Perak, MD, MS, Janet M. Catov, PhD, MS, Natalie A. Bello, MD, MPH, Simon Capewell, DSc, MD, Martin O'Fla

Other Northwestern writers include Drs. Philip Greenland, Nilay S. Shah, Amanda M. Perak, Lucia C. Petito, and Donald M. Lloyd-Jones.

The National Heart, Lung, and Blood Institute of the National Institutes of Health provided funding for this study through award number 1R01HL161514.

By NORTHWESTERN UNIVERSITY

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