Poster Session 4
Category: Health Equity/Community Health
Poster Session 4
Noor K. Al-Shibli, MD (she/her/hers)
MFM Fellow
Emory University School of Medicine
Emory University School of Medicine, Georgia, United States
Elizabeth C. Rhodes, MS, PhD
Rollins School of Public Health, Emory University
Atlanta, Georgia, United States
Erin Ferranti, MPH, PhD (she/her/hers)
Nell Hodgson Woodruff School of Nursing, Dept of Gynecology & Obstetrics, Emory University
Nell Hodgson Woodruff School of Nursing, Dept of Gynecology & Obstetrics, Emory University/ Atlanta, Georgia, United States
Anne L. Dunlop, MD, MPH
Department of Gynecology and Obstetrics, Division of Research, Emory University School of Medicine
Dept of Gynecology & Obstetrics, Division of Research, Emory University School of Medicine/ Atlanta, Georgia, United States
Suchitra Chandrasekaran, MD, MSCE
Associate Professor
Department of Gynecology and Obstetrics, Emory University School of Medicine
Atlanta, Georgia, United States
Food deserts (FD), regions with limited access to nutritious/affordable foods, are emerging threats to cardiometabolic health in non-pregnant states. In pregnancy, the burden of metabolic diseases, including hypertensive disorders of pregnancy (HDP) is rising. Given the known links between social determinants of health & cardiometabolic outcomes, we aimed to examine the association between residence in a FD & the development of HDP.
Using our institutional obstetric database, we performed a retrospective cohort study of deliveries from 2016-2023 with documented zip-code & clinical/demographic data. FD status was assigned by zip-code of primary residence according to the U.S. Department of Agriculture (USDA) definitions. HDP was a composite of gestational hypertension (GHTN), preeclampsia with severe features (PRESF) & without severe features (PREWOSF). Kruskal Wallis & Chi square tests were performed to compare continuous & categorical variables, respectively. Poisson regression models, controlling for age, race, body mass index (BMI), & chronic hypertension (CHTN) were used to estimate incidence risk ratios (IRR).
Among N=21,065 pregnancies, 7,160 (34.0%) lived in a FD. Compared to non-FD residents, those in FDs had a higher BMI (30.2±7.9 vs 29.5±7.2, p< 0.001) & were younger (29.1±6.1 vs 29.8±6.1, p< 0.01). FD residents had higher rates of HDP (31.5% vs 29.0%, p< 0.01), GHTN (19.25% vs 17.3%, p=0.002), & CHTN (11.4% vs 9.2%, p< 0.001). Rates of PREWOSF (p=0.098) or PRESF (p=0.068) did not differ significantly between groups. While FD residence was not significantly associated with increased risk of HDP after adjustment, (IRR 1.05, 95% CI 0.98-1.18, p=0.14), it was associated with a 1.1-fold higher risk of developing GHTN (IRR 1.1, 95% CI 1.01-1.18, p=0.02).
Living in a FD is associated with an increased risk of GHTN, though not with HDP overall. Our findings underscore the need for future studies to explore mechanisms linking neighborhood-level inequities to maternal cardiometabolic health & develop interventions to advance perinatal health equity & outcomes.