TY - JOUR
T1 - Predictors of eclampsia in California
AU - Esakoff, Tania F.
AU - Rad, Steve
AU - Burwick, Richard
AU - Caughey, Aaron B.
N1 - Publisher Copyright:
© 2015 Informa UK Ltd.
PY - 2016/5/18
Y1 - 2016/5/18
N2 - Objective: Eclampsia is a rare yet dangerous complication of the hypertensive disorders of pregnancy. The objective was to elucidate the predictors of eclampsia in a large cohort of pregnant women with gestational hypertension or preeclampsia.Methods: This was a retrospective cohort study of 143 093 pregnancies with preeclampsia or gestational hypertension in California during 2005-2008 of which 1719 had eclampsia. Predictors included race/ethnicity, parity, chronic hypertension (CHTN), diabetes mellitus, gestational diabetes mellitus (GDM), preterm delivery <32 weeks, maternal age ≥ 35, maternal age ≤ 20, socioeconomic status, education, and <5 prenatal visits. Univariate and multivariate analyses were performed.Results: Factors that increased the risk of eclampsia included Black (OR 1.46 [1.19-1.80]) and Hispanic race (OR 1.56 [1.35-1.79]), nulliparity (OR 1.59 [1.42-1.77]), maternal age ≤ 20 (OR 1.85 [1.61-2.11]), preterm delivery <32 weeks (OR 1.41 [1.16-1.70]), and <5 prenatal care visits (1.74 [1.46-2.07]). Factors that decreased the risk of eclampsia included CHTN (OR 0.06 [0.03-0.10]), GDM (OR 0.80 [0.67-0.96]), maternal age ≥ 35 (OR 0.70 [0.59-0.82]), and college education (OR 0.83 [0.74-0.94]).Conclusions: Black and Hispanic race, nulliparity, maternal age ≤ 20, preterm delivery <32 weeks, and <5 prenatal care visits increase the risk of eclampsia while CHTN, GDM, maternal age ≥ 35, and college education are protective. The protective effect of CHTN is the most striking. The mechanisms are likely different and warrant further investigation.
AB - Objective: Eclampsia is a rare yet dangerous complication of the hypertensive disorders of pregnancy. The objective was to elucidate the predictors of eclampsia in a large cohort of pregnant women with gestational hypertension or preeclampsia.Methods: This was a retrospective cohort study of 143 093 pregnancies with preeclampsia or gestational hypertension in California during 2005-2008 of which 1719 had eclampsia. Predictors included race/ethnicity, parity, chronic hypertension (CHTN), diabetes mellitus, gestational diabetes mellitus (GDM), preterm delivery <32 weeks, maternal age ≥ 35, maternal age ≤ 20, socioeconomic status, education, and <5 prenatal visits. Univariate and multivariate analyses were performed.Results: Factors that increased the risk of eclampsia included Black (OR 1.46 [1.19-1.80]) and Hispanic race (OR 1.56 [1.35-1.79]), nulliparity (OR 1.59 [1.42-1.77]), maternal age ≤ 20 (OR 1.85 [1.61-2.11]), preterm delivery <32 weeks (OR 1.41 [1.16-1.70]), and <5 prenatal care visits (1.74 [1.46-2.07]). Factors that decreased the risk of eclampsia included CHTN (OR 0.06 [0.03-0.10]), GDM (OR 0.80 [0.67-0.96]), maternal age ≥ 35 (OR 0.70 [0.59-0.82]), and college education (OR 0.83 [0.74-0.94]).Conclusions: Black and Hispanic race, nulliparity, maternal age ≤ 20, preterm delivery <32 weeks, and <5 prenatal care visits increase the risk of eclampsia while CHTN, GDM, maternal age ≥ 35, and college education are protective. The protective effect of CHTN is the most striking. The mechanisms are likely different and warrant further investigation.
KW - California
KW - eclampsia
KW - predictors
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U2 - 10.3109/14767058.2015.1057489
DO - 10.3109/14767058.2015.1057489
M3 - Article
C2 - 26212587
AN - SCOPUS:84958106354
SN - 1476-7058
VL - 29
SP - 1531
EP - 1535
JO - Journal of Maternal-Fetal and Neonatal Medicine
JF - Journal of Maternal-Fetal and Neonatal Medicine
IS - 10
ER -