My study examines the incidence of risk factors among women giving birth in the United States in the year 2019, primarily African American Women. Among the risk factors associated with Hypertensive Disorders in Pregnancy, according to Wheelers et al. (2022), being African American is a risk factor for the hypertensive disorder of preeclampsia. This was a retrospective cohort study that used The National Center for Health Statistics birth certificate data to determine the number of pregnant women with moderate to high risk factors. In 2019 there were 3, 695,019 births, 528,778 with no risk and 169, 540 with 1 or more high risk factors, and 2,996,701 with 1 or more moderate risk factors in thre community. Aside from being African American other risk factors included: Multifetal gestation and low socioeconomic status were the two most common factors. Low socioeconomic status had an incidence of 46.9% in the moderate risk factor category and multifetal gestation had an incidence of 3.5% in the high-risk factor for developing preeclampsia. in addition to multifetal gestation, was pregestational diabetes and chronic hypertension. Preeclampsia is the leading cause for maternal and fetal morbidity and mortality due to the fact is causes growth restriction of the fetus, increases the chances of caesarian delivery, raises the risk of long-term maternal cardiovascular health issues. in this study, not only did the clinicians want to determine the incidence of preeclampsia, but they also sought to determine whether or not low dose aspirin could decrease the risk of preeclampsia in women with two or more associated risk factors.
In using Medicaid as a payer and participation in the women Infant program as markers for low-economic status, they also determined that race measures an individuals lived experience with racism.
This study may have met in answering the question related to incidence of preeclampsia and the risk factors that are associated with it both high-risk and moderate risk but did not answer the question as to the association of African American women having a higher incidence. Instead, extrapolated low-socioeconomic with possibly being African American. Yes, African American have higher incidence of diabetes and chronic hypertension, but that association with what was presented in this article was weak. On the other hand, did low dose aspirin significantly decrease preeclampsia with there known risk factors? Yes it did , as the main measure was to examine prevalence of these risk factor alone or in combination. The 2021 guidelines for moderate and high-risk factors for preeclampsia would benefit from a low dose aspirin regimen for those that met criteria for inclusion. Low dose aspirin is most effective if started by 16 weeks of pregnancy. Of course due to this being a cohort study, it is observational. So, the study design was to observe how effective low dose aspirin would be in decreasing the preeclampsia if the participant was determined to fir criteria according to their risk factors.
Wheeler, S. M., Myers, S. O., Swamy, G. K., & Myers, E. R. (2022). Estimated Prevalence of Risk Factors for Preeclampsia Among Individuals Giving Birth in the US in 2019. JAMA Network Open, 5(1), e2142343. https://doi-org.lopes.idm.oclc.org/10.1001/jamanetworkopen.2021.42343
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