Racial/Ethnic Disparities in the Association Between Preeclampsia Risk Factors and Preeclampsia Among Women Residing in Hawaii
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Objective To assess differences in the rates of preeclampsia among a multiethnic population in Hawaii. Methods We performed a retrospective study on statewide inpatient data for delivery hospitalizations in Hawaii between January 1995 and December 2013. Multivariable logistic regression was used to assess the impact of maternal race/ethnicity on the rates of preeclampsia after adjusting for age, multiple gestation, multiparity, chronic hypertension, pregestational diabetes, obesity and smoking. Results A total of 271,569 hospital discharges for delivery were studied. The rates of preeclampsia ranged from 2.0 % for Chinese to 4.6 % for Filipinos. Preeclampsia rates were higher among Native Hawaiians who are age <35 and non-obese (OR 1.54; 95 % CI 1.43–1.66), age ≥35 and non-obese (OR 2.31; 95 % CI 2.00–2.68), age ≥35 and obese (OR 1.80; 95 % CI 1.24–2.60); other Pacific Islanders who are age <35 and non-obese (OR 1.40; 95 % CI 1.27–1.54), age ≥35 and non-obese (OR 2.18; 95 % CI 1.79–2.64), age ≥35 and obese (OR 1.68; 95 % CI 1.14–2.49); and Filipinos who are age <35 and non-obese (OR 1.55; 95 % CI 1.43–1.67), age ≥35 and non-obese (OR 2.26; 95 % CI 1.97–2.60), age ≥35 and obese (OR 1.64; 95 % CI 1.04–2.59) compared to whites. Pregestational diabetes (OR 3.41; 95 % CI 3.02–3.85), chronic hypertension (OR 5.98; 95 % CI 4.98–7.18), and smoking (OR 1.19; 95 % CI 1.07–1.33) were also independently associated with preeclampsia. Conclusions for Practice In Hawaii, Native Hawaiians, other Pacific Islanders and Filipinos have a higher risk of preeclampsia compared to whites. For these high-risk ethnic groups, more frequent monitoring for preeclampsia may be needed.
KeywordsPreeclampsia Eclampsia Health care disparities Minority health
Dr. Nakagawa was supported in part by the research grant from the National Institute on Minority Health and Health Disparities of the National Institutes of Health (NIH) (P20MD000173). Dr. Lim was partially supported by the Grant U54MD007584 from the NIH. The content is solely the responsibility of the authors and does not necessarily reflect the official opinion of the NIH.
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