Journal Article10.1097/HJH.0B013E3282FCC36E
Low socioeconomic status is a risk factor for preeclampsia: the Generation R Study
Lindsay M. Silva,Marianne Coolman,Eric A.P. Steegers,Vincent W. V. Jaddoe,Henriëtte A. Moll,Albert Hofman,Johan P. Mackenbach,Hein Raat +7 more
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TL;DR: Low maternal socioeconomic status is a strong risk factor for preeclampsia, and only a small part of this association can be explained by the mediating effects of established risk factors for preeClampsia.
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Abstract: Objectives: To examine whether maternal socioeconomic status, as indicated by maternal educational level, is associated with preeclampsia, and if so, to what extent known risk factors for preeclampsia mediate the effect of educational level.
Methods: In the Generation R Study, a population-based cohort study, we examined data of 3547 pregnant women. Odds ratios of preeclampsia for low, mid-low and mid-high educational level compared with high educational level were calculated after adjustment for confounders and additional adjustment for a selection of potential mediators (family history, material factors, psychosocial factors, substance use, working conditions, preexisting medical conditions, maternal anthropometrics and blood pressure at enrolment) that individually caused more than 10% change in the odds ratio for low education.
Results: Adjusted for the confounding effects of age, gravidity and multiple pregnancy, women with low educational level were more likely to develop preeclampsia (odds ratio 5.12; 95% confidence interval: 2.20, 11.93) than women with high educational level. After additional adjustment for financial difficulties, smoking in pregnancy, working conditions, body mass index and blood pressure at enrolment, the odds ratio was 4.91 (95% confidence interval: 1.93, 12.52).
Conclusion: Low maternal socioeconomic status is a strong risk factor for preeclampsia. Only a small part of this association can be explained by the mediating effects of established risk factors for preeclampsia. Further research is needed to disentangle the pathway from low socioeconomic status to preeclampsia.
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Citations
The Generation R Study: design and cohort update 2010
Vincent W. V. Jaddoe,Cock M. van Duijn,Albert J. van der Heijden,Johan P. Mackenbach,Henriëtte A. Moll,Eric A.P. Steegers,Henning Tiemeier,André G. Uitterlinden,Frank C. Verhulst,Albert Hofman +9 more
TL;DR: The Generation R Study is a population-based prospective cohort study designed to identify early environmental and genetic causes and causal pathways leading to normal and abnormal growth, development and health from fetal life, childhood and young adulthood.
Clinical risk factors for pre-eclampsia determined in early pregnancy: systematic review and meta-analysis of large cohort studies
TL;DR: A practical evidence based list of clinical risk factors that can be assessed by a clinician at ≤16 weeks’ gestation to estimate a woman’s risk of pre-eclampsia and the use of aspirin prophylaxis in pregnancy is developed.
847
Clinical Risk Factors for Preeclampsia Determined in Early Pregnancy: Systematic Review and Meta-Analysis of Large Cohort Studies
TL;DR: A meta-analysis of cohort studies examining risk factors for preeclampsia identified multiple risk factors that could be used to identify early in pregnancy women who are at “high risk” of developing preeClampsia.
The role of inflammation in the pathology of preeclampsia.
Ashlyn C Harmon,Denise C. Cornelius,Lorena M. Amaral,Jessica L. Faulkner,Mark W. Cunningham,Kedra Wallace,Babbette LaMarca +6 more
TL;DR: These studies show that restoring the balance of the immune system through increasing Tregs, either by adoptive transfer or by infusing IL-10, reduces the blood pressure and pathophysiology associated with placental ischaemia in pregnant rats.
494
Clinical risk prediction for pre-eclampsia in nulliparous women: development of model in international prospective cohort
Robyn A. North,Lesley M. E. McCowan,Gustaaf A. Dekker,Lucilla Poston,Eliza H. Y. Chan,Alistair Stewart,Michael A. Black,Rennae S. Taylor,James J. Walker,Philip N. Baker,Louise C. Kenny +10 more
TL;DR: The ability to predict pre-eclampsia in healthy nulliparous women using clinical phenotype is modest and requires external validation in other populations.
420
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