In November 2020, a woman named Lupe neared the end of her pregnancy when dark spots started affecting her vision. As part of a study on emotional stress and maternal health in El Paso, Texas, she described her experience in a postpartum interview. All names, including Lupe’s, are pseudonyms for privacy.
Sensing something wrong, Lupe went to the emergency room. Her blood pressure measured 167 over 98, far above her normal 115 over 70 from her first prenatal visit. She received a quick diagnosis of preeclampsia, a serious condition involving high blood pressure and possible organ damage.
Prompt care stopped her symptoms from worsening. Without it, the condition can lead to brain bleeds, heart issues, organ failure and seizures. Preeclampsia ranks as a top cause of maternal deaths globally.
The authors, a medical anthropologist and human biologist in El Paso, examine social influences on preeclampsia. In the first two years of the COVID-19 pandemic, they found nearly 25 percent prevalence among 176 Latinas using public prenatal care in El Paso. The national rate stood near 8 percent in 2021.
El Paso and Juarez, Mexico, form one of the largest binational metro areas. Over 80 percent of El Paso’s nearly 700,000 residents identify as Latino. The city has long faced high poverty, with 35 percent of households reporting food insecurity in 2023.
The researchers view El Paso as key to understanding how social inequities create biological risks for preeclampsia.
Preeclampsia has complex causes. It may stem from irregular placenta attachment to the uterine wall, though not all such cases progress. Experts cite environmental, social and personal factors in its development.
A complication is eclampsia, or seizures from vascular damage affecting the brain. Severe organ harm, stroke and other symptoms can prove fatal even without seizures. Delivery of the baby and placenta usually stops progression. Labor induction and symptom management can save lives.
Elevated stress, environmental toxins, COVID-19 infection in pregnancy and extreme heat may trigger physiological responses leading to preeclampsia.
Globally, about 4.4 percent of pregnancies involve preeclampsia, with higher rates in low- and middle-income countries. Sub-Saharan Africa shows the highest regional rate at 13 percent.
In the U.S., the rate rose from 4.5 percent in 2008 to 8 percent in 2021 amid the pandemic. Racial and ethnic minorities face higher rates.
The team focuses on social factors behind the high preeclampsia risk in El Paso and lessons for other disadvantaged groups.
In El Paso, multiple social and environmental conditions likely drive the elevated rate. Risk factors include economic insecurity, past trauma, severe mental health symptoms, racism and discrimination. These stressors may spark physiological responses tied to the condition.
Research occurred after the 2019 mass shooting in El Paso, during heightened immigration tensions and the region’s heavy COVID-19 burden. Participants qualified for public prenatal care and faced major economic and social challenges. Many had transnational family ties or immigrant relatives. About 21 percent reported an immediate family member deported or detained.
Participants are not fully representative of El Paso, as the study focused on low-income women eligible for public benefits and recruited from t
