Journal of Obstetrics and Gynaecology Canada
Volume 34, Issue 4, 2012, Pages 348-352

Serious Preeclampsia Among Different Immigrant Groups (Article)

Urquia M.L. , Ying I. , Glazier R.H. , Berger H. , De Souza L.R. , Ray J.G.
  • a Centre for Research on Inner City Health, St. Michael's Hospital, Toronto, ON, Canada, Institute for Clinical Evaluative Sciences, Toronto, ON, Canada
  • b Department of Medicine, Schulich School of Medicine and Dentistry, London, ON, Canada
  • c Centre for Research on Inner City Health, St. Michael's Hospital, Toronto, ON, Canada, Institute for Clinical Evaluative Sciences, Toronto, ON, Canada, Department of Family and Community Medicine, University of Toronto and St. Michael's Hospital, Toronto, ON, Canada
  • d Department Obstetrics and Gynecology, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada
  • e Department Obstetrics and Gynecology, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada
  • f Institute for Clinical Evaluative Sciences, Toronto, ON, Canada, Department Obstetrics and Gynecology, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada, Department of Medicine, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada, Department of Health Policy Management and Evaluation, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada

Abstract

Objective: Research conducted outside Canada suggests that preeclampsia (PET) may be more common among certain ethnic groups. A limitation to prior studies is that they did not distinguish between immigrant and non-immigrant women; they also included women with mild PET arising near term, the clinical importance of which is debatable. We created the term "serious PET" to describe a diagnosis of severe PET, eclampsia, or any degree of PET with concomitant preterm delivery, fetal death, or maternal hospitalization of seven days or more, and evaluated its risk in association with world region of origin among recent immigrants to Ontario. Methods: Using the federal Landed Immigrant Data System database (LIDS), we completed a population-based study of 18 849 women who immigrated to Ontario between 1985 and 2000. The LIDS was linked to the Canadian Institute for Health Information's Discharge Abstracts Database, thereby capturing all hospitalizations with subsequent delivery in Ontario between April 1, 2002, and March 31, 2009. Rates for serious PET were determined according to maternal world region of birth, and odds ratios were adjusted for maternal age, number of live births, multifetal pregnancy, diabetes mellitus status, level of formal education, place of residence, neighbourhood income quintile, duration of residence in Canada, and fiscal year of delivery. Results: Immigrant women from the Caribbean (6.8 per 1000; OR 3.34; 95% CI 2.25 to 4.96), Sub-Saharan Africa (6.8 per 1000; OR 3.14; 95% CI 2.04 to 4.83) and Hispanic America (5.9 per 1000; OR 3.11; 95% CI 1.97 to 4.88) were at highest risk of serious PET relative to immigrant women from industrialized nations. The ORs were either unchanged or higher when restricted to women without a prior live birth. Conclusion: We identified immigrant groups at higher risk of serious PET, whose consequences would presumably include greater financial costs for hospital care and a negative impact on maternal and newborn well-being. © 2012 Society of Obstetricians and Gynaecologists of Canada.

Author Keywords

Eclampsia Pregnancy Preeclampsia Length of stay PET preeclampsia Hypertension LIDS Landed Immigrant Data System Ethnicity Stillbirth race Immigration Prematurity

Index Keywords

immigrant hospitalization Africa south of the Sahara human risk assessment statistics health service data base Developed Countries controlled study Central America ethnology Hispanic Americans Humans ethnic difference Hispanic labor induction Canada Emigrants and Immigrants female medical information system pregnancy high risk population population research Caribbean Region Caribbean Article Ontario major clinical study adult migration preeclampsia developed country disease severity Pre-Eclampsia
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-84863780588&doi=10.1016%2fS1701-2163%2816%2935215-X&partnerID=40&md5=d6f4100f142b8b3964f874d2ff01a3b2
DOI: 10.1016/S1701-2163(16)35215-X
ISSN: 17012163
Cited by: 30
Original Language: English