Abstract
To evaluate contemporary trends in hypertensive disorders of pregnancy (HDP) prevalence by race and ethnicity, we conducted a cross-sectional study of 33,363,927 U.S. live births from 2016 through 2024 using National Vital Statistics System data. Age-standardized HDP rates increased by 74%, from 62.7 to 109.1 per 1,000 live births (average annual percent change 7.2%; p<0.001), with an inflection point occurring in 2021. This increment occurred across all racial and ethnic groups, with the highest relative increases among non-Hispanic Asian (9.7% annually) and Multiracial individuals (7.9% annually). By 2024, absolute HDP rates were highest among non-Hispanic American Indian or Alaska Native individuals (143.7/1,000) and non-Hispanic Black individuals (132.7/1,000).