Predictors of eclampsia in California*. (18th May 2016)

• Record Type: Journal Article
• Authors: Esakoff, Tania F.; Rad, Steve; Burwick, Richard M.; Caughey, Aaron B.
• Is Part Of: Journal of maternal-fetal & neonatal medicine. Volume 29:Number 10(2016)
• Page Start: 1531
• Page End: 1535
• Publication Date: 2016-05-18
• Subjects: California -- eclampsia -- predictors; Obstetrics -- Periodicals; Perinatology -- Periodicals; Infants (Newborn) -- Diseases -- Periodicals; Neonatology -- Periodicals; 618.2
• DOI: 10.3109/14767058.2015.1057489
• Languages: English
• ISSNs: 1476-7058

Abstract

Abstract: 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.