Relationship Between Trauma and Trauma-Related Psychopathology and the Development of Gestational Hypertension in Black Individuals Restricted; Files Only

Abstract

Hypertensive diseases of pregnancy (HDP), encompassing gestational hypertension, preeclampsia, and preeclampsia superimposed on chronic hypertension, present significant risks to maternal and fetal health, contributing to adverse outcomes such as myocardial infarction, stroke, and mortality for birthing persons, and fetal growth restriction (FGR) with subsequent neonatal complications. Despite global efforts to address HDP, the United States experiences a concerning rise in maternal morbidity and mortality, secondary to HDP, particularly among low-income Black women in the southern US. regions.

Trauma exposure, stress-related psychopathologies such as depression and post-traumatic stress disorder (PTSD), and their potential impact on HDP development remain poorly understood. Given the elevated and disproportionate prevalence of HDP as well as trauma and trauma-related psychopathologies among Black pregnant individuals, there is a critical need to explore their association with HDP in this population.

A total of 137 pregnant women (≥ 18 years old) with singleton pregnancies were used in our analysis. Of the 137 enrolled, 102 participants did not have HDP, and 35 did. Socio-demographic and medical characteristics were comprehensively assessed, revealing no significant differences between HDP and non-HDP groups, except for a higher prevalence of diabetes among HDP participants. Univariate analysis found no statistically significant associations between predictors (childhood trauma, PTSD diagnosis, Depression diagnosis) and HDP occurrence. Mediation analysis suggested PTSD and Depression may mediate the association between childhood trauma and HDP, although not reaching statistical significance.

Our findings underscore the importance of screening for childhood trauma and psychopathologies in pregnancy, particularly among Black individuals, to mitigate HDP risk. Further research is needed to elucidate underlying mechanisms and mediators in HDP pathogenesis, aiding comprehensive maternal healthcare and addressing the maternal morbidity and mortality crisis in the United States.

Table of Contents

1. Introduction

2. Materials and Methods

3. Results

4. Discussion

5. Grants

6. Disclosures

7. References

About this Master's Thesis

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School	Laney Graduate School
Department	Clinical Research
Degree	M.S.
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Obstetrics and Gynecology Health Sciences, Mental Health
Keyword	hypertensive disorders of pregnancy cardiometabolic disease adverse pregnancy outcomes African American Black PTSD trauma exposure depression gestation pregnant
Committee Chair / Thesis Advisor	Jordan Kempker, Emory University
Committee Members	Vasiliki Michopoulos, Emory University

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