Pregnancy-related mortality in Hispanic women in the United States

Hopkins, Frederick W; MacKay, Andrea P.; Koonin, Lisa M.; Berg, Cynthia J.; Irwin, Molly; Atrash, Hani K.

doi:10.1016/s0029-7844(99)00393-2

Cited by 29 publications

(27 citation statements)

References 6 publications

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“…12,21,23 Others, however, did not find a difference in the frequency of the two alleles. [24][25][26] Our findings are similar to those of Hopkins et al 27 who showed a higher frequency of T allele in Hispanic women with PE. A meta-analysis involving 17 studies concluded that C allele homozygotes had a 1.62 times higher risk of developing PE.…”

Section: Discussionsupporting

confidence: 91%

Endothelial nitric oxide synthase, angiotensin-converting enzyme and angiotensinogen gene polymorphisms in hypertensive disorders of pregnancy

2010

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We investigated the variations in genes encoding endothelial nitric oxide synthase (NOS3), angiotensin-converting enzyme (ACE) and angiotensinogen (AGT) in hypertensive disorders of pregnancy and the relationship between the polymorphisms and circulating nitric oxide (NO) and ACE levels in pregnant north Indian women. Frequencies of NOS3 G894T, 4b/a and T -786 -C, AGT T704C and ACE ins/del polymorphisms were studied in 342 subjects: 120 with preeclampsia (PE), 104 with gestational hypertension and 118 normotensive pregnant women. Variations were evaluated by polymerase chain reactionrestriction fragment length polymorphism. NO and ACE levels were determined using ELISA. There was no difference in the distribution of individual NOS3 and ACE polymorphisms in the study groups. Haplotype analysis showed a global difference in the NOS3 haplotype distribution between the PE and non-PE subjects (P¼0.03). The presence of AGT 704C allele was associated with a reduced risk of developing PE (odds ratio: 0.33, 95% CI: 0.19-0.59 in recessive mode). Circulating total NO and ACE levels were similar in three groups. No relationship was found between circulating NO levels and any of the NOS3 polymorphisms, but the circulating ACE levels were higher in those with DD genotype (Po0.05). In conclusion, there was no association between individual NOS3 and the ACE gene polymorphisms and hypertensive disorders of pregnancy in north Indian women. The presence of minor alleles at all the three sites in NOS3 seemed to increase the risk of PE, and AGT 704C allele was associated with a reduced PE risk. The complexity of interaction between these genetic abnormalities requires further studies.

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Section: Discussionsupporting

confidence: 91%

Endothelial nitric oxide synthase, angiotensin-converting enzyme and angiotensinogen gene polymorphisms in hypertensive disorders of pregnancy

2010

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“…Despite higher levels of poverty than the other race/ethnicity groups (22% Medicaid insurance vs. 10% for nonHispanic Whites and 18% for non-Hispanic Blacks), Hispanic mothers had significantly longer gestations and better rates of fetal growth. Other researchers have also reported better outcomes in Hispanic mothers compared to non-Hispanic Black mothers, but worse outcomes compared to their non-Hispanic White counterparts (Buekens et al, 2000;Chung et al, 2003;Hessol & Fuentes-Affleck, 2000;Hopkins et al, 1999;Kieffer et al, 1999;Leslie et al, 2003;Scholl et al, 2002). In our study, Hispanic mothers had the highest average birthweight and the longest length of gestation, as well as the lowest proportions of low birthweight, very low birthweight, preterm and early preterm births of the three race/ethnicity groups.…”

Section: Discussionsupporting

confidence: 59%

The Hispanic Paradox in Twin Pregnancies

et al. 2005

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“…10 The reasons for this excess maternal mortality remain unclear. Whereas few European studies have looked at this subject, 11,12 many studies carried out in the USA have attempted to explain the excess of mortality of the AfricanAmerican women, [13][14][15][16][17] but they used racial categories specific to the US context. More generally, racial or ethnic category does not cover the notion of migration that we have prioritised.…”

Section: Introductionmentioning

confidence: 99%

Can excess maternal mortality among women of foreign nationality be explained by suboptimal obstetric care?

Philibert

Deneux‐Tharaux

Bouvier‐Colle

2008

BJOG

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Objectives To test the hypothesis that the risk of postpartum maternal death in France remains significantly higher for women of foreign nationality after individual characteristics are taken into account and to examine whether the quality of care received by the women who died differs according to nationality.Design A national case-control study. Setting Metropolitan France.Population A total of 267 women who died of maternal death from 1996 to 2001 as cases and a representative sample (n = 13 186) of women who gave birth in 1998 as controls.Methods Crude and adjusted odd ratios were calculated with multivariate logistic regression, and the quality of care for cases was compared according to nationality with chi-square tests or Fisher's exact tests.Main outcome measures Odd ratio for postpartum maternal death associated with nationality and quality of care.Results After taking individual characteristics into account, the risk of postpartum maternal death was twice as high for foreign women. The odds ratio was 5.5 (95% CI: 3.3-9.0) for women from sub-Saharan Africa and 3.3 (95% CI: 1.7-6.5) for those from Asia, North and South America. There was no significant excess risk of postpartum maternal death for the other European and North Africa women. The risk of dying from hypertensive disorder or infection was four times higher for foreign women. Among women who died, care was more often considered not optimal for foreign women (78 versus 57%).Conclusions The excess risk of postpartum maternal death persisted for foreign women after individual characteristics were taken into account and was especially important for some nationalities and for some causes of death, primarily hypertensive disorders. These results point to an immediate need to pay special attention to early enrolment in prenatal care, screening and prenatal management of hypertension, especially in women of sub-Saharan African nationality.Keywords Maternal mortality, nationality, quality of care.Please cite this paper as: Philibert M, Deneux-Tharaux C, Bouvier-Colle M. Can excess maternal mortality among women of foreign nationality be explained by suboptimal obstetric care?

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Pregnancy-related mortality in Hispanic women in the United States

Cited by 29 publications

References 6 publications

Endothelial nitric oxide synthase, angiotensin-converting enzyme and angiotensinogen gene polymorphisms in hypertensive disorders of pregnancy

Endothelial nitric oxide synthase, angiotensin-converting enzyme and angiotensinogen gene polymorphisms in hypertensive disorders of pregnancy

The Hispanic Paradox in Twin Pregnancies

Can excess maternal mortality among women of foreign nationality be explained by suboptimal obstetric care?

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