Evidence mapPaperPMID 41908550Full record

ArticleExposome2026

The spatial and contextual exposome and subtypes of hypertensive disorders of pregnancy: a double machine learning-based analysis.

Hui Hu, Claire L Leiser, Xing He, Jaime E Hart, Francine Laden, Cui Tao, Jiang Bian

Abstract read
In one paragraph

Article in Exposome, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

7 authors.

Hui HuChanning Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, United States.ORCID https://orcid.org/0000-0002-7482-9060
Claire L LeiserChanning Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, United States.
Xing HeDepartment of Biostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis, IN 46202, United States.
Jaime E HartChanning Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, United States.
Francine LadenChanning Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, United States.
Cui TaoDepartment of Artificial Intelligence and Informatics, Mayo Clinic, Jacksonville, FL 32224, United States.
Jiang BianDepartment of Biostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis, IN 46202, United States.

Funding

Semantics Standards and Tools for Spatial and Contextual Exposome DataR24ES036131 · INDIANA UNIVERSITY INDIANAPOLIS · 2025 to 2025
$656k
Hypertensive Disorders of Pregnancy and Early Risk of Maternal CVD: Influence of the External ExposomeK01HL153797 · BRIGHAM AND WOMEN'S HOSPITAL · 2025 to 2025
$159k
NHLBI NIH HHS K01 HL153797NIEHS NIH HHS R24 ES036131
6 · The paper itself

Abstract

Hypertensive disorders of pregnancy (HDP) are a leading cause of maternal and perinatal morbidity, yet modifiable environmental risk factors remain poorly characterized. Prior studies typically have only examined a limited number of exposures and have rarely distinguished HDP subtypes (ie, gestational hypertension, preeclampsia, eclampsia, and chronic hypertension with or without superimposed preeclampsia) or accounted for residential mobility during pregnancy. To address these gaps, we conducted a spatial and contextual exposome study of HDP using linked electronic health records (EHR) and vital statistics data in Florida. We analyzed 686 412 singleton pregnancies conceived between 2013 and 2018, using computable phenotyping to distinguish HDP subtypes. A total of 245 spatial and contextual exposome measures spanning natural, built, and social environments were linked to residential histories from conception through gestational week 19. Using a two-phase double machine learning (DML) framework with exposure-specific, directed acyclic graph-guided confounder adjustment, we conducted discovery and replication analyses, followed by multi-treatment DML to estimate effect sizes. In Phase 1, 26 exposome measures replicated for gestational hypertension and 34 for overall HDP. In Phase 2, 12 measures remained associated with gestational hypertension and 11 with overall HDP, including air toxicants, meteorological factors, ultraviolet radiation, neighborhood crime indicators, environmental noise, and proximity to coastline. No exposures passed multiple-comparison thresholds for preeclampsia or eclampsia. These findings demonstrate that the spatial and contextual exposome contributes to HDP in a subtype-specific manner. Integrating EHR-linked phenotyping, residential mobility, and causal machine-learning methods offers a scalable framework for identifying environmental factors relevant to HDP prevention.

Indexed as

causal machine learningeclampsiaexposomegestational hypertensionhypertensive disorders of pregnancypreeclampsiaspatial

Identifiers

PMID41908550
PMCPMC13017162

What Socratic holds

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.