Prevalence of most preeclampsia risk factors increased from 2010 to 2021 in US
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Key takeaways:
- From 2010 to 2021, most high and moderate risk factors for preeclampsia increased in the U.S.
- Multifetal gestation and nulliparity were the only preeclampsia risk factors to decrease during this period.
Most high and moderate risk factors for preeclampsia have increased from 2010 to 2021 in the U.S., according to a research letter published in JAMA.
“High risk factors for preeclampsia include chronic hypertension, pregestational diabetes, history of preeclampsia, multifetal gestation, autoimmune disease and kidney disease. Moderate risk factors include nulliparity, advanced maternal age, body mass index greater than 30, interpregnancy interval of greater than or equal to 10 years, family history of preeclampsia, certain sociodemographic characteristics and IVF,” Mariam K. Ayyash, MD, MSCR, clinical fellow in the division of maternal-fetal medicine at Columbia University Irving Medical Center, and colleagues wrote. “Trends in risk factors have not been evaluated since a study in a single medical center using data from 1988 to 2014.”
Ayyash and colleagues used data from the National Vital Statistics System database to identify all 46,526,529 live births from 24 to 42 weeks’ gestation in the U.S. from 2010 to 2021. All patients in the population-based retrospective study presented to prenatal care before 16 weeks gestation.
Overall, 32,752,948 live births were included in the study. From 2010 to 2021, researchers observed increased rates of some high risk factors for preeclampsia such as chronic hypertension (1.2% to 2.7%; P < .001) and pregestational diabetes (0.7% vs. 1.1%; P < .001). Conversely, multifetal gestation decreased from 1.7% in 2010 to 1.2% in 2021 (P < .001).
Among moderate risk factors for preeclampsia, obesity (22.5% to 30.5%), advanced maternal age (14.7% to 20.1%), IVF (0.5% to 1.5%) and interpregnancy interval (5.6% to 6.3%) increased from 2010 to 2021 (P < .001 for all). However, nulliparity decreased from 42.8% in 2010 to 40% in 2021 (P < .001).
In addition, hypertensive disorders of pregnancy also increased from 4.4% in 2010 to 9.4% in 2021 (P < .001).
“Public health efforts to reduce modifiable risk factors of preeclampsia, such as chronic hypertension, pregestational diabetes and obesity, should be emphasized,” the researchers wrote.