Estimated Prevalence of Risk Factors for Preeclampsia Among Individuals Giving Birth in the US in 2019.
JAMA Netw Open
; 5(1): e2142343, 2022 01 04.
Article
em En
| MEDLINE
| ID: mdl-34982156
ABSTRACT
Importance Low-dose aspirin (LDA) is one of the few evidence-based interventions for preventing preeclampsia, which is a leading cause of maternal or fetal morbidity and mortality. Current guidelines recommend LDA based on the presence of risk factors for preeclampsia, but the population-based prevalence of these factors is unknown. Objective:
To estimate population-level prevalence of preeclampsia risk factors used in prophylactic LDA guidelines for pregnant patients and the association of these risk factors with reported rates of pregnancy-related hypertension. Design, Setting, andParticipants:
A retrospective cohort study was conducted using National Center for Health Statistics birth certificate data to describe the frequency of pregnant individuals with moderate to high-risk factors for preeclampsia and pregnancy-related hypertension rates. The study used all birth records in the United States for the 2019 calendar year. Exposures Documentation of preeclampsia risk factors multifetal gestation, pregestational diabetes, chronic hypertension (high-risk factors) and nulliparity, a body mass index greater than 30, African American race, a maternal age 35 years or older, an interval of more than 10-years since last birth, and having low socioeconomic status (moderate risk factors). Main Outcomes andMeasures:
Prevalence of each risk factor alone and in combinations leading to a recommendation for LDA; incidence of pregnancy-related hypertension by risk factor and combinations of risk factors.Results:
There were 3â¯695â¯019 pregnancies in 2019, including 528â¯778 with no risk factors, 169â¯540 with 1 or more high-risk factors, and 2â¯996â¯701 with 1 or more moderate-risk factors. The mean (SD) of the cohort was 29.1 (5.8) years. Multifetal gestation was the most common high-risk factor and found in 123â¯995 pregnancies (3.4%), and low socioeconomic status was the most common moderate-risk factor and present in 1â¯732â¯729 pregnancies (46.9%). Based on 2021 criteria (a single high- or moderate-risk factors for preeclampsia), 3â¯166â¯241 pregnant patients (85.7%) were eligible for LDA. The incidence of pregnancy-related hypertension increased with the number of moderate-risk factors. The 2021 guidelines suggest considering or recommend LDA in 92.3% of pregnancies diagnosed with pregnancy-related hypertension. Conclusions and Relevance These data support the recently published guidelines and suggest further simplified guidelines recommending LDA to patients with any single moderate-risk factors.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Pré-Eclâmpsia
Tipo de estudo:
Etiology_studies
/
Guideline
/
Observational_studies
/
Prevalence_studies
/
Risk_factors_studies
Limite:
Adult
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Female
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Humans
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Pregnancy
País como assunto:
America do norte
Idioma:
En
Ano de publicação:
2022
Tipo de documento:
Article