Social inequalities in women’s long term health after hypertensive disorders of pregnancy - Better understanding for better prevention – Hyper-Soc

Hypertensive disorders of pregnancy (HDP) complicate 5 to 10% of pregnancies and are likely to affect women’s health in the years following pregnancy. Specifically, HDP are associated with an increased risk of developing renal and cardiovascular diseases in the medium and long term. The risk of developing adverse renal and cardiovascular outcomes can be reduced through preventive care: providing regular medical follow-up, informing women about their risk, screening and monitoring of risk factors, encouraging women to initiate and maintain healthy behaviours (physical activity and nutrition), and through timely initiation of pharmacological treatment. The association between socioeconomic status (SES) and adequate utilization of healthcare services has been well documented. We therefore hypothesize that social inequalities exist in the development of long term adverse outcomes after HDP. However, the association between SES and long term effects of HDP has not been explored yet in high income countries. We propose to use data from the French National Health Data system (SNDS) and data from the EDP-Santé to understand how SES modifies the effect of HDP on long term health outcomes. From a national cohort of women who experienced HDP, built from the SNDS database, our objectives are (i) to quantify the medium-long term risk after HDP and investigate the association between specific dimensions of socioeconomic status and this risk, (ii) to investigate women’s healthcare utilization in the years following HDP by mapping out their healthcare pathways and describing them according to their socioeconomic status, (iii) to explore how factors such as comorbidities and healthcare pathways may mediate the association between socioeconomic status and long term risk. In the two years of the Access-ERC postdoctoral fellowship, I plan to publish two scientific articles, initiating scientific output and allowing me to identify unforeseen challenges. It will also give me the opportunity to organize an international research seminar on a central methodological aspect of the research project: the measure of socioeconomic status in longitudinal analyses in life course approaches. Finally, I will be able to develop international collaborations within the International Network of Obstetric System Survey (INOSS), taking this research project further and building an ERC Starting grant proposal with cross-national comparisons and analyses.