The prevalence of pre‐eclampsia in migrant relative to native Norwegian women: a population‐based study

Naimy, Zainab; Grytten, Jostein; Monkerud, Lars Chr.; Eskild, Anne

doi:10.1111/1471-0528.12978

Cited by 37 publications

(55 citation statements)

References 40 publications

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“…Our results are in line with similar findings in Swedish studies that women born outside of Nordic countries had at least a similar or lower risk of HDP than women born in Nordic countries . An earlier study from Norway assessing deliveries in a time period with a lower number of immigrants in Norway than in our study (1986‐2005) compared specific immigrant groups with Norwegian women and found similar or lower prevalence and risk of preeclampsia among immigrants, with the exception of Somalis . In our study, the prevalence of PE was highest among women born in sub‐Saharan Africa, but after adjustment with other covariates these women had a similar risk of PE compared with Norwegian‐born women.…”

Section: Discussionsupporting

confidence: 92%

“…The strength of this study is its large population‐based dataset of almost 1 million deliveries during the study period, with a previously published validation study showing high validity of the preeclampsia diagnosis in the MBRN . All foreign‐born women delivering in Norway were included in this study, not merely specific immigrant groups as in previous studies . We performed multivariate regression analyses, which describe the complex covariation of the assessed risk factors.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

The association of maternal country of birth and education with hypertensive disorders of pregnancy: A population‐based study of 960 516 deliveries in Norway

Sole

Staff

Laine

2018

Acta Obstet Gynecol Scand

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

The association of maternal country of birth and education with hypertensive disorders of pregnancy: A population‐based study of 960 516 deliveries in Norway

Sole

Staff

Laine

2018

Acta Obstet Gynecol Scand

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show abstract

“…Similar rates have been reported in other Nordic countries: according to the Danish hospital discharge registry 2.72% of women who gave birth in Northern Sealand in years 1998–2000 had preeclampsia [22]. In the medical birth registry data of Norway, covering 1 million births in years 1986–2005, preeclampsia rate was 3.7% [23]. While no validation studies exist for preeclampsia diagnoses in the Finnish healthcare registers, studies of the Norwegian [24] and Danish [22] registries have been validated against medical records according to criteria similar to those used in the present study.…”

Section: Discussionsupporting

confidence: 68%

Cluster analysis to estimate the risk of preeclampsia in the high-risk Prediction and Prevention of Preeclampsia and Intrauterine Growth Restriction (PREDO) study

et al. 2017

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ObjectivesPreeclampsia is divided into early-onset (delivery before 34 weeks of gestation) and late-onset (delivery at or after 34 weeks) subtypes, which may rise from different etiopathogenic backgrounds. Early-onset disease is associated with placental dysfunction. Late-onset disease develops predominantly due to metabolic disturbances, obesity, diabetes, lipid dysfunction, and inflammation, which affect endothelial function. Our aim was to use cluster analysis to investigate clinical factors predicting the onset and severity of preeclampsia in a cohort of women with known clinical risk factors.MethodsWe recruited 903 pregnant women with risk factors for preeclampsia at gestational weeks 12+0–13+6. Each individual outcome diagnosis was independently verified from medical records. We applied a Bayesian clustering algorithm to classify the study participants to clusters based on their particular risk factor combination. For each cluster, we computed the risk ratio of each disease outcome, relative to the risk in the general population.ResultsThe risk of preeclampsia increased exponentially with respect to the number of risk factors. Our analysis revealed 25 number of clusters. Preeclampsia in a previous pregnancy (n = 138) increased the risk of preeclampsia 8.1 fold (95% confidence interval (CI) 5.7–11.2) compared to a general population of pregnant women. Having a small for gestational age infant (n = 57) in a previous pregnancy increased the risk of early-onset preeclampsia 17.5 fold (95%CI 2.1–60.5). Cluster of those two risk factors together (n = 21) increased the risk of severe preeclampsia to 23.8-fold (95%CI 5.1–60.6), intermediate onset (delivery between 34+0–36+6 weeks of gestation) to 25.1-fold (95%CI 3.1–79.9) and preterm preeclampsia (delivery before 37+0 weeks of gestation) to 16.4-fold (95%CI 2.0–52.4). Body mass index over 30 kg/m2 (n = 228) as a sole risk factor increased the risk of preeclampsia to 2.1-fold (95%CI 1.1–3.6). Together with preeclampsia in an earlier pregnancy the risk increased to 11.4 (95%CI 4.5–20.9). Chronic hypertension (n = 60) increased the risk of preeclampsia 5.3-fold (95%CI 2.4–9.8), of severe preeclampsia 22.2-fold (95%CI 9.9–41.0), and risk of early-onset preeclampsia 16.7-fold (95%CI 2.0–57.6). If a woman had chronic hypertension combined with obesity, gestational diabetes and earlier preeclampsia, the risk of term preeclampsia increased 4.8-fold (95%CI 0.1–21.7). Women with type 1 diabetes mellitus had a high risk of all subgroups of preeclampsia.ConclusionThe risk of preeclampsia increases exponentially with respect to the number of risk factors. Early-onset preeclampsia and severe preeclampsia have different risk profile from term preeclampsia.

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“…Another limitation is the lack of data on ethnicity. Immigrant women have more often preterm birth [20], but less often preeclampsia [21]. Thus, the association between preterm birth and later preeclampsia would likely not be caused by failure of adjusting for ethnicity.…”

Section: Discussionmentioning

confidence: 99%

Predicting preeclampsia from a history of preterm birth

2017

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ObjectiveTo assess whether women with a history of preterm birth, independent on the presence of prelabour rupture of the membranes (PROM) and growth deviation of the newborn, are more likely to develop preeclampsia with preterm or preterm birth in a subsequent pregnancy.MethodsWe conducted a population-based cohort study, based on Medical Birth Registry of Norway between 1967 and 2012, including 742,980 women with singleton pregnancies who were followed up from their 1st to 2nd pregnancy. In the analyses we included 712,511 women after excluding 30,469 women with preeclampsia in the first pregnancy.ResultsAfter preterm birth without preeclampsia in the first pregnancy, the risk of preterm preeclampsia in the second pregnancy was 4–7 fold higher than after term birth (odds ratios 3.5; 95% confidence interval (CI) 3.0–4.0 to 6.5; 95% CI 5.1–8.2). The risk of term preeclampsia in the pregnancy following a preterm birth was 2–3 times higher than after term birth (odds ratios 1.6; 95% CI 1.5–1.8 to 2.6; 95% CI 2.0–3.4). After spontaneous non-PROM preterm birth and preterm PROM, the risk of preterm preeclampsia was 3.3–3.6 fold higher than after spontaneous term birth. Corresponding risks of term preeclampsia was 1.6–1.8 fold higher. No significant time trends were found in the effect of spontaneous preterm birth in the first pregnancy on preterm or term preeclampsia in the second pregnancy.ConclusionsThe results suggest that preterm birth, regardless of the presence of PROM, and preeclampsia share pathophysiologic mechanisms. These mechanisms may cause preterm birth in one pregnancy and preeclampsia in a subsequent pregnancy in the same woman. The association was particularly evident with preterm preeclampsia.

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The prevalence of pre‐eclampsia in migrant relative to native Norwegian women: a population‐based study

Cited by 37 publications

References 40 publications

The association of maternal country of birth and education with hypertensive disorders of pregnancy: A population‐based study of 960 516 deliveries in Norway

The association of maternal country of birth and education with hypertensive disorders of pregnancy: A population‐based study of 960 516 deliveries in Norway

Cluster analysis to estimate the risk of preeclampsia in the high-risk Prediction and Prevention of Preeclampsia and Intrauterine Growth Restriction (PREDO) study

Predicting preeclampsia from a history of preterm birth

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