Abstract
Background: Hypertensive disorders of pregnancy (HDP) remain a leading cause of maternal and perinatal morbidity in the United States. Despite advances in care, recent data suggest a rising prevalence.
Method: Using National Center for Health Statistics (NCHS) National Vital Statistics System (NVSS) natality data from 2014–2023 (n = 37.7 million births), we examined temporal trends, risk factors, and outcomes associated with chronic hypertension (CH), gestational hypertension (GH), and eclampsia.
Results: HDP affected 9.9% of all pregnancies, increasing substantially across all racial/ethnic groups. Maternal obesity was the strongest modifiable predictor, with extreme obesity conferring >6-fold higher odds of HDP. Non-Hispanic (NH) Black mothers had consistently higher prevalence of every subtype. HDP was strongly associated with preterm birth and low birth weight.
Conclusion: Findings suggest that rising HDP burden reflects both true epidemiologic shifts and improved diagnostic awareness, with implications for prenatal care, equity-focused interventions, and intergenerational cardiometabolic health.