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Abstract
This descriptive study aimed to identify the impact of psychosocial risk factors on pregnancy outcomes for high risk women in an urban setting. Women in this category tend to experience adverse pregnancy outcomes, like preeclampsia, at greater rates than low or medium risk women. A retrospective paper chart review of East Harlem women served by LSA Family Health Service (LSA) Maternal Outreach Program (MOP) was conducted. All women who enrolled in the MOP with a singleton pregnancy from January 2015 to December 2017, were eligible for inclusion in our analyses. Data were analyzed using SPSS (version 23). Of 379 total participants, 68.6% (n = 203) were Hispanic/Latina women, 44.8% (n = 163) were English only speakers, 67.4% (n = 226) were identified as overweight/obese, 90.6% (n = 328) were mothers over the age of 20 among those for whom data were available. Sixty-two percent (n = 235) initiated prenatal care in their first trimester, and 71.5% (n = 271) were referred to the MOP by a hospital or other healthcare provider. The percentage of preeclampsia among mothers was 26.9% (n = 102). After adjustment for type of LSA services received, and race/ethnicity, there were no associations between psychosocial risk factors and preeclampsia diagnosis in this population. Further research is needed on the relationship between psychosocial risk factors and preeclampsia to identify potential areas of intervention and reduce the burden of disease.
Keywords: Preeclampsia, home visits, nursing, social determinants of health, pregnancy
Introduction
Preeclampsia is a disorder of pregnancy that is characterized by new onset hypertension along with cerebral or visual symptoms, pulmonary edema or laboratory abnormalities indicating thrombocytopenia, transaminitis or renal dysfunction, during pregnancy or immediately postpartum (1). The diagnosis can be present at any stage of gestation but is more commonly encountered in the third trimester or up to six weeks postpartum (2). The prevalence of preeclampsia and other pregnancy related hypertensive disorders is estimated to be between 2-8% globally (3-5). Hypertensive pregnancy disorders are responsible for more than one quarter of maternal deaths in Latin America and the Caribbean (3). In the United States, racial and ethnic disparities in the prevalence of preeclampsia persist. One study found that Mexican women had higher preeclampsia rates compared to non-Hispanic White and East Asian...