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J Perinatol. 2016 Sep;36(9):718-22. doi: 10.1038/jp.2016.73. Epub 2016 May 5.

Preterm preeclampsia in relation to country of birth.

Author information

1
Keenan Research Centre, Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, ON, Canada.
2
University of Toronto, Toronto, ON, Canada.
3
Institute for Clinical Evaluative Sciences, Toronto, ON, Canada.
4
Department of Obstetrics and Gynaecology, St Michael's Hospital, Toronto, ON, Canada.
5
Maternal and Infant Health Section, Public Health Agency of Canada, Ottawa, ON, Canada.

Abstract

OBJECTIVE:

To examine the association between maternal country of birth and the risk of preeclampsia+preterm birth (PTB).

STUDY DESIGN:

We completed a population-based study in the entire province of Ontario, where there is universal access to obstetrical care. We included 881 700 singleton livebirths among Canadian-born mothers and 305 547 births among immigrant mothers. Adjusted risk ratios (aRRs) were adjusted for maternal age, parity and income quintile.

RESULTS:

Compared with a rate of preeclampsia+PTB of 4.0 per 1000 among Canadian-born mothers, the aRR of preeclampsia+PTB at 24 to 36 weeks was significantly higher for immigrant women from Nigeria (1.79, 95% confidence interval (CI) 1.12 to 2.84), the Philippines (1.54, 95% CI 1.30 to 1.86), Colombia (1.68, 95% CI 1.04 to 2.73), Jamaica (2.06, 95% CI 1.66 to 2.57) and Ghana (2.12, 95% CI 1.40 to 3.21). The aRRs generally followed a similar pattern for secondary outcomes. Specifically, women from Ghana were at highest risk of preeclampsia+very PTB (4.55, 95% CI 2.57 to 8.06), and women from Jamaica at the highest risk of preeclampsia+indicated PTB (1.89, 95% CI 1.43 to 2.50).

CONCLUSION:

The risk of preeclampsia+PTB is highest among women from a select number of countries. This information can enhance initiatives aimed at reducing the risk of PTB related to preeclampsia.

PMID:
27149056
PMCID:
PMC5007604
DOI:
10.1038/jp.2016.73
[Indexed for MEDLINE]
Free PMC Article

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