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Poster Session 2

Category: Hypertension

Poster Session 2

(412) Trends in Hypertensive Disorders of Pregnancy Highlight Persistent Racial and Rural-Urban Disparities: A Statewide Analysis

Wednesday, February 11, 2026

3:30 PM - 5:00 PM

Submitting Author and Presenting Author(s)

Alyssa M. Solberg, BSc

University of Wisconsin-Madison School of Medicine and Public Health
Madison, Wisconsin, United States

Coauthor(s)

Kara K. Hoppe, DO, PhD (she/her/hers)

Associate Professor
University of Wisconsin School of Medicine and Public Health, Department of Obstetrics and Gynecology
Madison, Wisconsin, United States
RG

Ronald E. Gangnon, PhD

University of Wisconsin-Madison School of Medicine and Public Health, Department of Population Health Sciences
Madison, Wisconsin, United States
Jacqueline M. Powell, MD (she/her/hers)

University of Wisconsin School of Medicine and Public Health, Department of Obstetrics and Gynecology
Madison, Wisconsin, United States

Objective:
Hypertensive disorders of pregnancy (HDP) complicate 10% of pregnancies in the U.S. and are associated with an increased risk of morbidity and mortality. This study aims to characterize HDP incidence across Wisconsin (WI) by demographic variables and assess its contribution to trends in severe maternal morbidity (SMM).

Study Design:
We conducted a retrospective cohort study of all births in Wisconsin from 2017 to 2023 using Wisconsin Hospital Association data. HDP and its subtypes including chronic hypertension, gestational hypertension, pre-eclampsia, pre-eclampsia with severe features, and HELLP syndrome were identified using ICD-10 codes. Incidence rates of HDP per 10,000 births and average annual percent changes (AAPC) were estimated using Poisson regression, both overall and stratified by disease subtype, region, and race/ethnicity. SMM was defined using CDC criteria. We applied the above methods to assess SMM incidence, AAPCs, and the most prevalent SMM indicators by HDP status.

Results:
Among 388,250 pregnancies analyzed, the incidence of nearly all subtypes of HDP increased from 2017 to 2023. Severe pre-eclampsia had the highest AAPC at 11.8% (95% CI, 10.6-13%). HDP incidence was highest in urban areas, though the AAPC in pre-eclampsia was greater in rural versus urban areas at 8.7% (95% CI, 7.1–10.3%, p = 0.004). Non-Hispanic Black patients experienced higher incidences of nearly all HDP subtypes, with significant differences in AAPC for HDP overall, chronic hypertension, and severe pre-eclampsia across racial/ethnic groups (p < 0.001). Patients with HDP had higher rates of SMM compared to those without, though the AAPC in SMM did not significantly differ by HDP status.

Conclusion:
Our findings highlight a growing burden of HDP in Wisconsin, with a notable rise in severe preeclampsia and disparities by geography and race. Targeted interventions in rural areas and for non-Hispanic Black patients are needed to reduce preeclampsia risk and SMM across WI. By shedding light on state-level disparities, studies like this can offer insight into the overall national landscape of maternal health.