Abstract P192: The Incidence of Pre-Eclampsia Remains Higher in African-American Women Compared to Caucasian Women: Trends from the National Hospital Discharge Survey 1979-2006
BACKGROUND: African-American women are at higher risk for pre-eclampsia compared to Caucasian women, but it remains unknown if there are any changes in the incidence of pre-eclampsia by race over time. We compared the national trends in the incidence of pre-eclampsia between African-American and Caucasian U.S. women from 1979-2006 and hypothesized that the trends between both racial groups would decrease and converge.
METHODS: We analyzed the incidence of pre-eclampsia in African-American and Caucasian women from the National Hospital Discharge Survey from 1979-2006. We calculated age-adjusted incidence rates and estimated trends of the rate of pre-eclampsia. We estimated the race-specific incidence of pre-eclampsia adjusting for age, geographic region, diabetes, essential hypertension, prior myocardial infarction, heart failure, benign essential hypertension complicating a pregnancy, transient hypertension, and gestational diabetes.
RESULTS: From 1979-2006, there were 4,644 African-American women and 12,131 Caucasian women for whom a delivery was associated with pre-eclampsia. There was an increasing trend in pre-eclampsia rates from 1979-2006 between African-Americans and Caucasians respectively at 0.76 and 0.29. However, there was an initial trend reduction from 1979-1988 in incidence of pre-eclampsia in African-Americans that was not seen in Caucasians, respectively -0.96 and 0.12. (Figure 1) Throughout the study, the rate ratio for pre-eclampsia remained higher for African-Americans versus Caucasians, minimum 0.98 (95% CI 0.96-1.0) to maximum 1.60 (95% CI 1.58-1.63).
CONCLUSION: In the last decade, there was a disparate increase in the incidence of pre-eclampsia in African-American women compared to Caucasian women. This may be explained by the changing characterization of pre-eclampsia, out-of-hospital births, changing access to prenatal care, and the racial reporting system. Further study is needed to address this response and its effect on cardiovascular disease risks.
- © 2013 by American Heart Association, Inc.