Hypertensive disorders during pregnancy are the second most common cause of maternal fatalities globally and may be leading to a notable increase in the number of pregnant individuals visiting emergency departments.
From 2006 to 2020, a rise was observed in both emergency visits and hospital admissions related to this condition, which can result in severe complications for both mothers and newborns. It is responsible for 6.3% of all pregnancy-related deaths in the United States.
This research, published in JAMA Network Open, also indicates that the use of emergency services for this condition is more pronounced among underrepresented racial and ethnic communities.
“Hypertensive disorders can arise suddenly, even in women who appear healthy, with warning signs that can escalate quickly,” stated senior author Erica Marsh, M.D., who is a professor of obstetrics and gynecology at the University of Michigan Medical School as well as chief of the reproductive endocrinology and infertility division at U-M Health Von Voigtlander Women’s Hospital, part of Michigan Medicine.
“In an ideal situation, this risk should be identified during prenatal care, leading to early treatment. Our findings suggest that more individuals are seeking help in emergency departments, which could indicate either an increased frequency of the condition or a greater awareness leading to quicker decisions for assessment and care.”
Hypertensive disorders in pregnancy can encompass conditions such as preeclampsia, gestational hypertension, and eclampsia, all of which are serious issues linked to high blood pressure.
The American College of Obstetricians and Gynecologists advises that instances of severe hypertension in pregnant individuals should be treated within 30 to 60 minutes of being diagnosed to avert complications, including stroke, myocardial ischemia, seizures, placental abruption, as well as maternal and neonatal deaths.
Disparities in Emergency Department usage and disease severity
The researchers evaluated data that represents the national landscape, revealing a 76% increase in emergency visits for this condition over the 14 years, climbing from 31,623 to 55,893. Hospital admissions nearly doubled, increasing from 17,338 to 43,563.
Factors potentially influencing this rise include worries about costs, lack of time, misconceptions around the necessity of seeking early treatment, or obstacles in accessing prenatal care.
“The differences in reliance on emergency rooms for this condition could suggest limited availability of timely outpatient services or other barriers within the healthcare system,” commented lead author Courtney Townsel, M.D., M.Sc., who was based at Michigan Medicine during the research and now works at the University of Maryland.
Individuals from Black, Hispanic, and Asian or Pacific Islander backgrounds were found to be more likely to both seek emergency care and be hospitalized for hypertensive disorders during pregnancy.
“The higher rates of hospital admissions among specific racial and ethnic groups imply that the severity of the condition is greater by the time they seek medical assistance,” remarked Townsel.
“These racial variances in the use of emergency care for hypertensive pregnancy disorders highlight the persistent racial inequalities regarding maternal health issues in the United States and point to an urgent need for accessible and culturally sensitive community-level interventions for everyone.”
