(645) Associations Between Social Disadvantage Indices and Hypertension in Pregnancy in the United States.

While individual-level social determinants of health have been linked to hypertensive disorders in pregnancy, less is known about the relationship between community-level social disadvantage and gestational hypertension.
To evaluate the association between four county-level social disadvantage indices and gestational hypertension rates among U.S. live births. We hypothesized that higher levels of social disadvantage would correlate with higher rates of gestational hypertension.

Study Design:
This was a retrospective, cross-sectional study using county-level gestational hypertension data from the CDC WONDER database (2018 to 2022). Four indices were evaluated: the Social Vulnerability Index (SVI), Social Vulnerability Metric (SVM), Social Deprivation Index (SDI), and Maternal Vulnerability Index (MVI). Each index captures dimensions of socioeconomic disadvantage using varying combinations of demographic, economic, housing, and health-related indicators. Counties were grouped into quartiles from least to most disadvantaged for each index. Gestational hypertension rates per 1,000 live births were compared between the most and least disadvantaged quartiles. Differences were considered statistically significant if 95% confidence intervals (CIs) did not overlap.

Results:

Data from 570 counties were included, representing 77.7% of all U.S. live births. For all four indices (SVI, SVM, SDI, MVI), there were no statistically significant differences in gestational hypertension rates between the most and least disadvantaged quartiles. Confidence intervals overlapped across all comparisons.

Conclusion:
Contrary to our hypothesis, county-level social disadvantage was not associated with an increased rate of gestational hypertension.