A first-of-its-kind analysis on medical records for a diverse group of about 6,000 Black, Hispanic, and white women have added evidence that some combination of social, biological, and cultural factors - not just race alone - is likely behind the higher rats of preeclampsia in Black women born in America, compared to Black women that immigrated to the country.
Data gathered on preeclampsia, including a severe form of high blood pressure that could be deadly for both the fetus and mother, were gathered over the course of 28 years of the Boston Birth Cohort. The study was originally designed to look into the genetic and environmental factors linked with premature births.
US Born vs Immigrant: Preeclampsia Disparity
The study published in the Journal of the American Medical Association, titled "Nativity-Related Disparities in Preeclampsia and Cardiovascular Disease Risk Among a Racially Diverse Cohort of US Women," was led by researchers from Johns Hopkins Medicine, that specifically analyzed differences in hypertension and other cardiovascular diseases risk factors and the prevalence of preeclampsia in Hispanic, Black and white women. The results of the novel analysis suggest that all three groups of women analyzed in the study that gave birth and were born in the US had a significantly higher risk of cardiovascular diseases than their foreign-born counterparts after checking their weight, alcohol use, smoking, diabetes, and stress.
For Black women, birth status outside of the Americas and a shortened duration of residence of no more than 10 years were linked with a 26% lower odds of preeclampsia. However, for white and Hispanic mothers, the length of residence and birth status had no significant association.
Overall, researchers say that the findings suggest that a person's nativity or place of birth is related to the disparity in preeclampsia in Black women and are not fully explained by the nativity differences in cardiovascular diseases or sociodemographic factors.
US Born Black Women Subjected to Higher Risks of Preeclampsia Compared to Foreign-Born Counterparts
In an article by EurekAlert, Garima Sharma, lead researcher of the study and director of cardio-obstetrics at the School of Medicine at Johns Hopkins University, said immigrants moved to the US to seek a better life. However, based on their research, there is unhealthy acculturation and assimilation.
According to her, the women that arrive in the US get unhealthier over time, most likely due to adopting habits of the dominant culture, which increases poorer health outcomes. Although the team didn't specifically analyze the impacts of structural racism on health for the study, Sharma says that it may play a vital role. Black women born outside the US and who immigrated to the country recently are somewhat protected from the effects of discrimination since they tend to settle in immigrant-concentrated areas with increased social support.
Sharma also emphasized that more research is necessary to explore the interplay of social and biological determinants of health contributing to disparities in pregnancy-related preeclampsia.
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