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Is ethnicity a risk factor for developing preeclampsia? An analysis of the prevalence of preeclampsia in China


Preeclampsia is a major complication of pregnancy. Risk factors for preeclampsia include population and regional ethnicity. Chinese women living outside the Chinese mainland have a lower prevalence of preeclampsia than resident Caucasians. We performed a retrospective study to identify potential factors that may be associated with developing preeclampsia in China. A total of 67 746 pregnant women were included in this study from 2002 to 2011. Data included maternal age, maternal body mass index (BMI), age at marriage, parity, gestation and blood pressure at diagnosis, proteinuria, and birth weight. In the study period, 1301 (1.92%) nulliparous women developed preeclampsia. The prevalence of mild or severe preeclampsia was 1.42% or 0.49%, respectively. The average BMI was 21.61 kg m−2. On the basis of the WHO BMI classification, 78.8% of women were of normal BMI, 18.3% were overweight and 2.9% were obese. A total of 37.8% of preeclamptic women had lived with the same partner for less than 1 year, which was significantly higher than those healthy pregnant women who did not develop preeclampsia (24.2%). The prevalence of preeclampsia in China is low compared with Causcasians, and the contribution to this lower prevalence may be dependent on BMI or lifestyle including period of cohabitation with the partner. Our data suggest that Chinese ethnicity may be a factor responsible for the low risk of developing preeclampsia in the populations studied.

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  1. Sibai B, Dekker GKupferminc M . Pre-eclampsia. Lancet 2005; 365: 785–799.

    Article  Google Scholar 

  2. Meis PJ, Goldenberg RL, Mercer BM, Iams JD, Moawad AH, Miodovnik M et al. The preterm prediction study: risk factors for indicated preterm births. Maternal-Fetal Medicine Units Network of the National Institute of Child Health and Human Development. Am J Obstet Gynecol 1998; 178: 562–567.

    Article  CAS  Google Scholar 

  3. Hogberg U . The World Health Report 2005: "Make every mother and child count" - Including Africans. Scand J Public Healt 2005; 33: 409–411.

    Article  Google Scholar 

  4. Berg CJ, Atrash HK, Koonin L, MTucker M . Pregnancy-related mortality in the United States, 1987-1990. Obstet Gynecol 1996; 88: 161–167.

    Article  CAS  Google Scholar 

  5. Duckitt KHarrington D . Risk factors for pre-eclampsia at antenatal booking: systematic review of controlled studies. BMJ 2005; 330: 565.

    Article  Google Scholar 

  6. Korish AA . Magnesium sulfate therapy of preeclampsia: an old tool with new mechanism of action and prospect in management and prophylaxis. Hypertens Res 2012; 35: 1005–1011.

    Article  CAS  Google Scholar 

  7. Steegers EA, von Dadelszen P, Duvekot J, JPijnenborg R . Pre-eclampsia. Lancet 2010; 376: 631–644.

    Article  Google Scholar 

  8. Knuist M, Bonsel GJ, Zondervan H, ATreffers PE . Risk factors for preeclampsia in nulliparous women in distinct ethnic groups: a prospective cohort study. Obstet Gynecol 1998; 92: 174–178.

    CAS  PubMed  Google Scholar 

  9. Sibai BM, Ewell M, Levine RJ, Klebanoff MA, Esterlitz J, Catalano PM et al. Risk factors associated with preeclampsia in healthy nulliparous women. The Calcium for Preeclampsia Prevention (CPEP) Study Group. Am J Obstet Gynecol 1997; 177: 1003–1010.

    Article  CAS  Google Scholar 

  10. Anderson NH, Sadler LC, Stewart AW, Fyfe E, MMcCowan LM . Ethnicity, body mass index and risk of pre-eclampsia in a multiethnic New Zealand population. Aust N Z J Obstet Gynaecol 2012; 52: 552–558.

    Article  Google Scholar 

  11. Caughey AB, Stotland NE, Washington A, EEscobar GJ . Maternal ethnicity, paternal ethnicity, and parental ethnic discordance: predictors of preeclampsia. Obstet Gynecol 2005; 106: 156–161.

    Article  Google Scholar 

  12. Gong J, Savitz DA, Stein C, REngel SM . Maternal ethnicity and pre-eclampsia in New York City, 1995-2003. Paediatr Perinat Epidemiol 2012; 26: 45–52.

    Article  Google Scholar 

  13. Rao AK, Daniels K, El-Sayed YY, Moshesh M, KCaughey AB . Perinatal outcomes among Asian American and Pacific Islander women. Am J Obstet Gynecol 2006; 195: 834–838.

    Article  Google Scholar 

  14. Shen JJ, Tymkow CMacMullen N . Disparities in maternal outcomes among four ethnic populations. Ethn Dis 2005; 15: 492–497.

    PubMed  Google Scholar 

  15. Lee CJ, Hsieh TT, Chiu TH, Chen KC, Lo L, MHung TH . Risk factors for pre-eclampsia in an Asian population. Int J Gynaecol Obstet 2000; 70: 327–333.

    Article  CAS  Google Scholar 

  16. Robillard PY, Hulsey TC, Perianin J, Janky E, Miri E, HPapiernik E . Association of pregnancy-induced hypertension with duration of sexual cohabitation before conception. Lancet 1994; 344: 973–975.

    Article  CAS  Google Scholar 

  17. Tanaka M, Jaamaa G, Kaiser M, Hills E, Soim A, Zhu M et al. Racial disparity in hypertensive disorders of pregnancy in New York State: a 10-year longitudinal population-based study. Am J Public Health 2007; 97: 163–170.

    Article  Google Scholar 

  18. Broughton Pipkin F . Risk factors for preeclampsia. N Engl J Med 2001; 344: 925–926.

    Article  CAS  Google Scholar 

  19. Tam CY, Hislop G, Hanley AJ, Minkin S, Boyd N, FMartin LJ . Food, beverage, and macronutrient intakes in postmenopausal Caucasian and Chinese-Canadian women. Nutr Cancer 2011; 63: 687–698.

    Article  CAS  Google Scholar 

  20. Atallah AN, Hofmeyr G, JDuley L Calcium supplementation during pregnancy for preventing hypertensive disorders and related problems. Cochrane Database Syst Rev, 2002; CD001059.

  21. Villar JBelizan JM . Same nutrient, different hypotheses: disparities in trials of calcium supplementation during pregnancy. Am J Clin Nutr 2000; 71: 1375S–1379SS.

    Article  Google Scholar 

  22. Yu CK, Teoh T, GRobinson S . Obesity in pregnancy. BJOG 2006; 113: 1117–1125.

    Article  CAS  Google Scholar 

  23. WHO Expert Consultation. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet 2004; 363: 157–163.

    Article  Google Scholar 

  24. Leung TY, Leung TN, Sahota DS, Chan OK, Chan LW, Fung TY et al. Trends in maternal obesity and associated risks of adverse pregnancy outcomes in a population of Chinese women. BJOG 2008; 115: 1529–1537.

    Article  CAS  Google Scholar 

  25. Salha O, Sharma V, Dada T, Nugent D, Rutherford AJ, Tomlinson AJ et al. The influence of donated gametes on the incidence of hypertensive disorders of pregnancy. Hum Reprod 1999; 14: 2268–2273.

    Article  CAS  Google Scholar 

  26. Robillard P, YHulsey TC . Association of pregnancy-induced-hypertension, pre-eclampsia, and eclampsia with duration of sexual cohabitation before conception. Lancet 1996; 347: 619.

    Article  CAS  Google Scholar 

  27. Klonoff-Cohen HS, Savitz DA, Cefalo R, CMcCann MF . An epidemiologic study of contraception and preeclampsia. JAMA 1989; 262: 3143–3147.

    Article  CAS  Google Scholar 

  28. Dekker GA, Robillard P, YHulsey TC . Immune maladaptation in the etiology of preeclampsia: a review of corroborative epidemiologic studies. Obstet Gynecol Surv 1998; 53: 377–382.

    Article  CAS  Google Scholar 

  29. Zhang J . Partner change, birth interval and risk of pre-eclampsia: a paradoxical triangle. Paediatr Perinat Epidemiol 2007; 21 (Suppl 1): 31–35.

    Article  CAS  Google Scholar 

  30. Fang J, Madhavan SAlderman MH . Low birth weight: race and maternal nativity—impact of community income. Pediatrics 1999; 103: E5.

    Article  CAS  Google Scholar 

  31. Stone JL, Lockwood CJ, Berkowitz GS, Alvarez M, Lapinski RBerkowitz RL . Risk factors for severe preeclampsia. Obstet Gynecol 1994; 83: 357–361.

    CAS  Google Scholar 

  32. Odegard RA, Vatten LJ, Nilsen ST, Salvesen K, AAustgulen R . Risk factors and clinical manifestations of pre-eclampsia. BJOG 2000; 107: 1410–1416.

    Article  CAS  Google Scholar 

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Correspondence to F Shen.

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Xiao, J., Shen, F., Xue, Q. et al. Is ethnicity a risk factor for developing preeclampsia? An analysis of the prevalence of preeclampsia in China. J Hum Hypertens 28, 694–698 (2014).

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  • prevalence of preeclampsia
  • China
  • BMI
  • Chinese ethnicity

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