IJE Advance Access published online on January 25, 2007
International Journal of Epidemiology, doi:10.1093/ije/dyl271
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Risk of early or severe preeclampsia related to pre-existing conditions
1 Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA.
2 Danish Epidemiology Science Center and Department of Epidemiology, School of Public Health, UCLA, Los Angeles, CA, USA.
* Corresponding author. Department of Epidemiology, University of pittsbugh, 130 Desoto street, Pittsbugh, PA 15261, USA. E-mail: jmcst43{at}pitt.edu
 |
Abstract |
|---|
Background Preeclampsia (PE), especially severe or early PE, is a leading cause of morbidity and mortality among mothers and infants. We estimated the population attributable fractions of severe or early PE associated with pre-existing conditions among nulliparous and multiparous women.
Methods Among 70 924 women in the Danish National Birth Cohort, we used hospital discharge data to identify 2117 cases of PE, of which 449 were early (<37 weeks), 426 were severe (clinically diagnosed) and 228 were both early and severe. Prospective interview data were supplemented with hospital registry data to identify women with pre-existing conditions. Generalized estimating equations were utilized to estimate adjusted relative risks, and population attributable fractions were calculated with 95% CI.
Results Pre-existing hypertension, diabetes, obesity or multiple gestation were associated with 22.3% (19.8–24.9) of all PE cases among nulliparous women. These conditions, or a prior preeclamptic pregnancy, were associated with 52.2% (46.4–57.9) of PE among multiparous women. Early PE was preceded by these pre-existing conditions among 34% (28.3–40.0) of affected nulliparous women and among 50% (37.5–63.4) of multiparous women. The fraction of severe PE associated with these conditions was 23% among nulliparas and 59% among multiparas. Being obese or overweight was associated with 15–17% of the population risk of early PE among nulliparous and multiparous women.
Conclusions Pre-existing maternal and obstetric conditions are associated with a high proportion of severe or early cases of PE. Obesity and overweight contributed independently to the risk of pre-term PE, a finding with potentially profound public health implications.
Keywords Preeclampsia, attributable fraction, chronic hypertension, obesity
Accepted 7 November 2006
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  J. M. Catov, E. A. Nohr, J. Olsen, and R. B. Ness Chronic Hypertension Related to Risk for Preterm and Term Small for Gestational Age Births Obstet. Gynecol., August 1, 2008; 112(2): 290 - 296. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. M Irgens Commentary: On the clinical prediction of pre-eclampsia and its enigmatic aetiology Int. J. Epidemiol., April 1, 2007; 36(2): 420 - 421. [Full Text] [PDF]
|
|