A Scoping Review of Risk Factors of Hypertensive Disorders of Pregnancy in Black Women Living in High-Income Countries: An Intersectional Approach

J Cardiovasc Nurs. 2024 Jul-Aug;39(4):347-358. doi: 10.1097/JCN.0000000000001085. Epub 2024 Mar 1.

Abstract

Background: Hypertensive disorders of pregnancy (HDP) are maternity-related increases in blood pressure (eg, gestational hypertension, preeclampsia, and eclampsia). Compared with women of other races in high-income countries, Black women have a comparatively higher risk of an HDP. Intersectionality helps to provide a deeper understanding of the multifactorial identities that affect health outcomes in this high-risk population.

Objective: In this review, we sought to explore the literature on HDP risk factors in Black women living in high-income countries and to assess the interaction of these risk factors using the conceptual framework of intersectionality.

Methods: We conducted this review using the Arksey and O'Malley methodology with enhancements from Levac and colleagues. Published articles in English on HDP risk factors with a sample of not less than 10% of Black women in high-income countries were included. Six databases, theses, and dissertations were searched from January 2000 to July 2021. A thematic analysis was used to summarize the results.

Results: A final total of 36 studies were included from the 15 480 studies retrieved; 4 key themes of HDP risks were identified: (1) biological; (2) individual traditional; (3) race and ethnicity, geographical location, and immigration status; and (4) gender related. These intersectional HDP risk factors intersect to increase the risk of HDP among Black women living in high-income countries.

Conclusion: Upstream approaches are recommended to lower the risks of HDP in this population.

Publication types

  • Review

MeSH terms

  • Black or African American / statistics & numerical data
  • Developed Countries*
  • Female
  • Humans
  • Hypertension, Pregnancy-Induced* / epidemiology
  • Hypertension, Pregnancy-Induced* / ethnology
  • Intersectional Framework
  • Pregnancy
  • Risk Factors