Description
- Abstract:
- Most of maternal deaths are preventable, and one-quarter of maternal deaths are due to hypertensive conditions of pregnancy, specifically pre-eclampsia and eclampsia. This thesis begins with a literature review on pre-eclampsia from medical, engineering, and public health points of view. Pre-eclampsia is defined clinically, and the biological basis of established risk factors are described. Technologies and statistical models that aid in advancing pre-eclampsia screening worldwide are also explored. The review has suggestions for more robust pre-eclampsia research: diversifying study sites, improving biomarker analytical tools, and more. The risk factor “African American race” did not have sufficient biological evidence despite African American individuals being at a higher risk of developing pre-eclampsia. Race is not a biological construct, yet researchers will often solely consider race as a risk factor when it has been shown that as a social determinant of health, how one is treated based on their race negatively affects their health. This thesis then examines the role of racism and/or discrimination in affecting one’s risk of developing a hypertensive disorder of pregnancy. Data from 17 sites that asked questions regarding experiences with racism and/or discrimination during pregnancy via the Pregnancy Risk Assessment Monitoring System (PRAMS) Phase 8 (2016-2020) from was used. Regression models were used to estimate odds of hypertensive disorder diagnosis in pregnancy using adjusted models controlling for confounders: biological risk factors, socioeconomic factors, and experiences of racism and/or discrimination. Among participants with live births (N = 69,751), 14.9% of participants stated they were diagnosed with hypertension during pregnancy with non-Hispanic and Hispanic Black individuals having the highest rates (19.8%). 13.1% of participants experienced racism and 15.6% of participants experienced discrimination. Experiencing racism or discrimination increased one’s odds of having hypertension during pregnancy by 1.14 times (CI: 1.00 - 1.31) and 1.30 times (CI: 1.02 - 1.65), respectively. When experiences with discrimination were included, Black individuals did not have statistically significantly higher odds of having hypertension during pregnancy compared to non-Hispanic White individuals. Experiences of racism and discrimination drive racial disparities in hypertensive disorders in pregnancy.
- Notes:
- Thesis (Sc. M.)--Brown University, 2022
Citation
Lee, Kiara R.,
"A review of the risk factors of pre-eclampsia and examination of the association of racism and discrimination in disparities of hypertensive disorders of pregnancy using multi-state PRAMS data"
(2022).
Public Health Theses and Dissertations.
Brown Digital Repository. Brown University Library.
https://repository.library.brown.edu/studio/item/bdr:bkefj9b2/
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Public Health Theses and Dissertations
Theses and Dissertations for the Public Health department....